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enA Portrait of Suffering: Syria after Five Years of Conflict (Webcast)https://www.doctorswithoutborders.org/portrait-suffering-syria-after-five-years-conflict-webcast
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<div class="field field-name-field-cta-home-link field-type-link-field field-label-above"><div class="field-label">Link:&nbsp;</div><div class="field-items"><div class="field-item even"><a href="http://www.doctorswithoutborders.org/syria-after-five-years">MORE</a></div></div></div><div class="field-collection-container clearfix"><div class="field field-name-field-summary-image field-type-field-collection field-label-above"><div class="field-label">Summary image:&nbsp;</div><div class="field-items"><div class="field-item even"><div class="field-collection-view clearfix view-mode-full field-collection-view-final"><div class="entity entity-field-collection-item field-collection-item-field-summary-image clearfix">
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<div class="field field-name-field-media-summary-image field-type-image field-label-above"><div class="field-label">Image:&nbsp;</div><div class="field-items"><div class="field-item even"><img src="https://media.msf.org/Docs/MSF/Media/TR1/c/2/2/9/MSF161534.jpg" width="1000" height="667" alt="MSF-supported hospital in northern Syria destroyed in attack" /></div></div></div><div class="field field-name-field-nmetadata-alt field-type-text field-label-above"><div class="field-label">Alt:&nbsp;</div><div class="field-items"><div class="field-item even">MSF-supported hospital in northern Syria destroyed in attack</div></div></div><div class="field field-name-field-nmetadata-country field-type-text field-label-above"><div class="field-label">Country:&nbsp;</div><div class="field-items"><div class="field-item even">Syria </div></div></div><div class="field field-name-field-nmetadata-title field-type-text field-label-above"><div class="field-label">Title:&nbsp;</div><div class="field-items"><div class="field-item even">MSF-supported hospital in northern Syria destroyed in attack</div></div></div><div class="field field-name-field-nmetadata-ost field-type-text field-label-above"><div class="field-label">Original submission title:&nbsp;</div><div class="field-items"><div class="field-item even">MSF-supported hospital in northern Syria destroyed in attack</div></div></div><div class="field field-name-field-nmetadata-caption field-type-text-long field-label-above"><div class="field-label">Caption:&nbsp;</div><div class="field-items"><div class="field-item even"><p>The MSF-supported hospital in Ma’arat Al Numan before it was attacked and destroyed on Monday 15th Feb. At least 25 people were killed, including nine staff members.<br />
The 30-bed hospital had 54 staff, two operating theatres, an outpatient department and an emergency room. The outpatient department treated around 1500 people a month, the ER carried out an average of 1,100 consultations a month, and around 140 operations a month, mainly orthopaedic and general surgery, were carried out in the operating theatres.</p>
<p>MSF has been supporting this hospital since September 2015 and covered all the needs of the facility including provision of medical supplies and running costs.</p>
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</div></div></div></div></div>Tue, 22 Mar 2016 22:55:41 +0000Jess Brown65561 at https://www.doctorswithoutborders.orghttps://www.doctorswithoutborders.org/portrait-suffering-syria-after-five-years-conflict-webcast#commentsSyriahttps://www.doctorswithoutborders.org/country-region/syria
<div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even"><h3>Syria: Latest MSF Updates</h3>
<ul><li><a href="https://www.doctorswithoutborders.org/article/jordan-access-medical-care-risk-syrian-refugees">Jordan: Access to Medical Care at Risk for Syrian Refugees</a></li>
<li><a href="https://www.doctorswithoutborders.org/article/northwest-syria-two-airstrikes-cause-mass-casualty-influx-msf-supported-hospital">Northwest Syria: Two Airstrikes Cause Mass-Casualty Influx to MSF-Supported Hospital</a></li>
<li><a href="https://www.doctorswithoutborders.org/article/syria-military-operations-eastern-ghouta-drastically-limit-medical-aid">Syria: Military Operations in Eastern Ghouta Drastically Limit Medical Aid</a></li>
<li><a href="https://www.doctorswithoutborders.org/article/syria-voice-hospital-basement-eastern-ghouta">Syria: Voice from a Hospital Basement in Eastern Ghouta</a><a href="https://www.doctorswithoutborders.org/article/syria-deadly-airstrikes-damage-hospital-supported-msf-idlib"><div class="media-element file-default" style=" width: 2264px;"><div class="media-image-wrapper"><img height="1402" width="2264" class="media-element file-default" style=" width: 2264px;" src="/sites/usa/files/map_syria_2016.jpg" alt="" title="" /></div></div></a></li>
</ul><p><em>This information is excerpted from MSF’s 2016 </em><em><a href="http://www.msf.org/sites/msf.org/files/msf_activity_report_2016_web.pdf"><em>International Activity Report</em></a>.</em></p>
<p>The extreme violence perpetrated against civilians during six years of war in Syria showed no sign of abating, as civilian areas were routinely bombed and deprived of assistance. Access to food and health care remained extremely poor, and many hospitals faced critical shortages of supplies and staff. Well over half of the Syrian population have been forced from their homes by the conflict.</p>
<p>MSF’s direct presence was significantly constrained in a country where it should be running some of its largest medical programs. The Syrian government did not grant MSF authorization to operate in the country, and insecurity limited MSF’s ability to provide assistance in areas controlled by the Islamic State group or other opposition forces. Nevertheless, in 2016, MSF continued to operate directly in six medical facilities in regions controlled by opposition forces across northern Syria and provided distance support to Syrian medical networks.</p>
<p>Medical facilities, staff, and patients were victims of indiscriminate and targeted attacks. In 2016, 32 medical facilities supported by MSF were bombed or shelled on 71 separate occasions. On February 15, an MSF-supported hospital in Ma’arat Al Numan, Idlib governorate, was hit by four missiles, killing twenty-five people. On April 27, at least 55 people were killed when airstrikes hit the MSF-supported Al Quds hospital and the surrounding neighborhood in Aleppo city.</p>
<p>Since 2014, MSF has provided regular medical supplies to eight hospitals, six health centers, and three first-aid points in eastern Aleppo city. Following the consolidation of the siege by the government-led coalition in July 2016, MSF halted activities, apart from the delivery of one shipment of approximately 100 tons of medical supplies. MSF kept in close contact with doctors and nurses in eastern Aleppo who testified to the immense suffering of people trapped in a city battered by bombing and shelling. In December, after the Syrian government took full control of Aleppo city, thousands of people from the eastern part were evacuated to rural areas of Idlib and Aleppo governorates. MSF ran mobile clinics, distributed relief items, and organized a vaccination campaign.</p>
<p>In Azaz district, north of Aleppo, MSF ran the 34-bed Al Salamah hospital, offering a wide range of services. In 2016, staff conducted 85,737 outpatient consultations, performed 1,598 surgical interventions, and admitted 3,692 patients. MSF delivered relief items and hygiene kits for displaced families trapped between the front line and the Turkish border, and also implemented a water and sanitation program in an informal settlement east of Azaz town.</p>
<p>In the Kobane/Ain al-Arab area of northern Syria, MSF worked alongside the local health administration to re-establish basic medical services. It supported nine primary health units, a maternity clinic, and two hospitals. In rural Jarablus, MSF partnered with a Turkish NGO to assist three primary health centers.</p>
<p>In the summer, when a military offensive caused civilians to flee Manbij, MSF scaled up its support to help meet the needs of the displaced and host communities.</p>
<p>MSF continued to run a 20-bed burn hospital in Atmeh, and also ran vaccination, health education, and disease surveillance activities in 180 surrounding camps and villages hosting approximately 165,000 internally displaced people. In Qunaya, MSF scaled up its distance support to the regional referral hospital and supported routine vaccination in Qunaya and Darkoush hospitals. Since 2013, MSF teams have offered primary health services in Hassakeh governorate, with a focus on mother and child care and chronic diseases.</p>
<p>Since 2011, MSF has supported a growing number of medical facilities in some of the areas worst affected by conflict. This program included donations of medicine, medical material, and relief items; distance training for staff inside Syria; technical medical advice; and financial support to keep the facilities running. In 2016, regular support was given to 80 medical structures across Syria, including in Aleppo, Dara’a, Hama, Homs, Idlib, Quneitra, and rural Damascus governorates. These facilities conducted more than 2.2 million outpatient consultations, 770,000 emergency room consultations, 225,000 surgeries, and assisted over 29,000 births. Ad hoc support, such as medical donations, was provided to an additional 80 medical facilities across the country. </p>
<h2>Update: April 2017</h2>
<p><em>In southern Syria, fighting intensified in February and March as opposing forces vied for control of the city of Dara´a. As bombings and aerial attacks in eastern Dara´a increased, hospitals and medical structures in the area were forced to close to avoid being targeted. Some residents have also witnessed civilian structures being targeted by airstrikes.</em></p>
<p><em>The fighting resulted in a surge of 30,000 internally displaced people. Many fled to surrounding farmlands or returned to villages previously abandoned and destroyed. Doctors Without Borders/Médecins Sans Frontières (MSF) is responding to this new crisis with an emergency distribution of 893 kits of essential relief items, distributed to families in two areas. <a href="/node/69711">Read more here</a>.</em></p>
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<h3 style="text-align: center;">Khan Sheikhoun Victims Show Symptoms Consistent with Exposure to Chemical Substances</h3>
<p>A Doctors Without Borders/Médecins Sans Frontières (MSF) medical team supporting the emergency department at Bab Al Hawa Hospital in Syria's Idlib Province has confirmed that patients' symptoms are consistent with exposure to a neurotoxic agent.</p>
<p>A number of victims of the April 4 attack on the town of Khan Sheikhoun were brought to the hospital, located about 60 miles to the north, near the Turkish border. Eight people who were examined by MSF staff displayed symptoms consistent with exposure to an agent such as sarin gas or similar compounds, including constricted pupils, muscle spasms and involuntary defecation.</p>
<p>The MSF team provided drugs and antidotes to treat patients, and distributed protective clothing to medical staff in the hospital's emergency room.</p>
<p>MSF medical teams also visited other hospitals treating victims of the attack, and reported that they smelled of bleach, indicative of possible exposure to chlorine.</p>
<p>These reports strongly suggest that victims of the attack on Khan Sheikhoun were exposed to at least two different chemical agents.</p>
<p><em>MSF directly operates four health facilities in northern Syria and provides support to more than 150 health facilities in Syria.</em></p>
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</tr></tbody></table><h3>Update, January 5, 2017: Assistance for Internally Displaced People from East Aleppo</h3>
<p><em>On December 26, a Doctors Without Borders/Médecins Sans Frontières (MSF) team began an assessment of needs in nine villages and towns in Syria's Idlib Governorate. Some organizations already provide health care in the area, but in two villages MSF identified a clear need for medical services. A mobile medical team began seeing patients in one of these locations on January 2, supported by two ambulances sent by MSF. As in other areas of Syria, the most common pathologies are respiratory infections, gastritis, and musculoskeletal pain. </em></p>
<p><em>Since the beginning of the intervention on December 15, MSF teams have distributed 1,328 non-food item kits (including hygiene kits, kitchen kits, winter kits, mattresses, and more), to internally displaced people from East Aleppo living with the host community in Idlib Governorate. Additionally, 300 winter kits (clothes, blankets and other items) were distributed in different areas of Idlib Governorate to people evacuated from East Aleppo and displaced people coming from the Northern Aleppo countryside. MSF also supports hospitals in the region with medical equipment and drugs and has provided a tent to support a mobile clinic and a generator, fuel, and supplies for blood transfusion to a maternity unit. </em></p>
<p><em>Reinforcing access to immunization is also a priority, as many people have gone without vaccines for four to six months. MSF continues to monitor the situation in order to ensure that there are no gaps in assistance provided to displaced people.</em></p>
<p><em>MSF currently supports 23 health facilities (health centers, hospitals, and maternity/pediatric centers) in Aleppo, Idlib, and Hama governorates with medications, medical kits, and cash for fuel. In one of the main hospitals, MSF continues to provide treatment for burns. At this location the MSF team receives an average of 150 patients per week in the emergency room, 60 percent of whom suffer from burns.</em></p>
<p>Despite the extent of the crisis and the needs, MSF’s presence and medical activities in Syria are significantly constrained, mainly due to insecurity but also due to a lack of agreements and authorizations. These constraints are as present today as they were a year and a half ago. To this date, the Syrian government has not granted MSF authorization to work in the country.</p>
<p>MSF nevertheless continues to directly operate six health facilities in the north of Syria, and puts significant energy into providing the best possible support to more than 150 health facilities countrywide, in areas where we cannot be directly present.</p>
<p>MSF teams also work in the countries neighboring Syria, providing assistance to refugees and host communities.</p>
<p></p><div class="media-youtube-video media-element file-wysiwyg media-youtube-2">
<iframe class="media-youtube-player" width="580" height="435" title="Month in Focus: March 2016 Special on Syria" src="//www.youtube.com/embed/uH9wODUyvdI?wmode=opaque" frameborder="0" allowfullscreen="">Video of Month in Focus: March 2016 Special on Syria</iframe>
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<h2>MSF and the Syrian Crisis</h2>
<p>After five and a half years of intense conflict, the situation in Syria keeps deteriorating, with ever-increasing unmet needs and suffering. It is estimated that 4.8 million people have fled the country, and another 6.5 million people are internally displaced (source: OCHA). This represents nearly 50 percent of the total population. </p>
<p>The “humanitarian system” is failing in Syria. Assistance, including access to food and medical supplies, remains appallingly insufficient. The pervasive daily reality for many people in Syria is one of fear, deprivation, and a struggle to survive. In many parts of the country access to medical care is dire due to a crumbling health system. Many hospitals face critical supply shortages, and there are ever-diminishing numbers of health workers, as medics have fled or been killed. From the beginning of the conflict medical staff and medical facilities have been targeted.</p>
<p>Even those people who manage to flee the front lines or besieged areas and reach the border find it increasingly difficult or even impossible to seek refuge abroad. Border restrictions and closures force people to return to the places in Syria they fled, or to camp out in the desert with no facilities or resources, at risk of violence, disease, and hunger. This is the case, for example, in the “berm,” where 75,000 Syrians are stranded between the Syrian and Jordanian borders.</p>
<p><iframe allowfullscreen="" frameborder="0" height="315" src="https://www.youtube.com/embed/uleCvN7iYT0" width="560"></iframe></p>
<h3>The Bombing of Hospitals</h3>
<p>Since the siege began in east Aleppo city in July 2016, functioning hospitals have been damaged in over 35 separate attacks. Some hospitals have been hit multiple times and have been forced to close as a result.</p>
<p>Most recently, multiple hospitals were hit by airstrikes from November 16, 2016, onwards, one day after airstrikes were relaunched on the opposition-held area of the city. Some hospitals came under attack more than once. Among those hit and taken out of service were a children’s hospital, two key hospitals specializing in surgery, and the largest general hospital. The pediatric hospital that was hit was the only specialized hospital for children in the besieged area. Hospital staff managed to move children, including premature babies, from cots and incubators to the basement of the building to shelter from the bombing. Both hospitals that were hit are supported by MSF, among other organizations.</p>
<p>Outside east Aleppo, hospitals supported by MSF have also been hit by bombing or shelling. </p>
<h3>MSF Projects in Syria</h3>
<h4><strong>Aleppo Governorate</strong></h4>
<p><em>For information on the situation in east Aleppo city, where people are suffering the consequences of the siege and the ceaseless targeted and indiscriminate bombing, see the latest MSF updates.</em></p>
<p>In Azaz District, MSF runs a 32-bed hospital (Al Salamah Hospital) which has an emergency room and also offers a wide range of services including outpatient and inpatient consultations, surgical care, and maternity and additional support services (pharmacy, laboratory, X-ray, etc). In addition, MSF teams can refer patients to other structures in Azaz District or in Turkey if they cannot be treated in the MSF hospital.</p>
<p>The number of internally displaced people in the area has significantly increased since last year, and this had led to a 45 percent increase in the number of consultations and admissions to our hospital.</p>
<p>Between January and August 2016, staff at the Al Salamah Hospital undertook 33,000 outpatient consultations, 1,765 inpatient consultations, 19,506 emergency room consultations, and 1,214 surgical interventions.</p>
<p>During the first few months of the year, MSF assisted new internally displaced people arriving in Azaz District, both in formal camps and informal provisional settlements. Non-food items and hygiene kits were distributed to 4,345 families (26,070 people) and tents were handed out to 1,330 families. A water and sanitation program was also implemented to improve living conditions in one of the informal settlements east of Azaz town.</p>
<p>In June, MSF launched a vaccination support program, with the objective of implementing regular vaccination activities in the northern districts of Aleppo Governorate targeting pregnant women and children under five.</p>
<h4><strong>Ein Al Arab/Kobane</strong></h4>
<p>In this area of northern Syria, MSF has worked alongside the local health administration since March 2015 to re-establish basic health facilities, provide outpatient health services, re-establish vaccination services, and implement psychological support programs throughout the area. Up until July 2016, there had been more than 50,000 outpatient consultations, over 8,000 emergency room consultations, and almost 2,000 inpatient admissions in MSF-supported structures in the area.</p>
<p>With shifting front lines and an offensive on Menbij by an armed group named the Syrian Democratic Forces (SDF; coalition of different groups in Syria), the number of civilians fleeing their home towards the areas surrounding the Euphrates River increased. </p>
<p>Both internally displaced Syrians and the host communities are in urgent need of humanitarian assistance. MSF scaled up its support to local health authorities in the region, and following an outbreak of measles supported the implementation of a ring vaccination campaign in the area east of the Euphrates River in northeastern Aleppo Governorate. Over 2,780 children were rapidly vaccinated against measles in communities that were suffering from the consequences of war and ground offensives. Local health response teams simultaneously conducted an emergency food distribution and screened all children who passed through the vaccination campaign for acute malnutrition.</p>
<p></p><div class="media media-element-container media-default"><div class="media-element file-default" style="width: 600px; height: 400px;"><div class="media-image-wrapper"><img height="667" width="1000" style="width: 600px; height: 400px;" title="The 30-bed MSF supported hospital was bombed, leaving the local population of 40,000 without access to medical services." class="media-element file-default" src="https://media.msf.org/Docs/MSF/Media/TR1/a/7/a/6/MSF161545.jpg" alt="" /><div class="field field-name-field-metadata-copyright field-type-text-long field-label-hidden"><div class="field-items"><div class="field-item even">MSF</div></div></div></div><div class="field-name-field-nmetadata-caption">The 30-bed MSF supported hospital was bombed, leaving the local population of 40,000 without access to medical services.</div>
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<h4><strong>Idlib Governorate</strong></h4>
<p>In Atmeh, in northwest Syria, close to the Bab al Hawa border, MSF runs a 15-bed burns hospital staffed by Syrian nationals and supported by an international team based in southern Turkey. The facility began as a trauma center in 2012 but, as needs for specialized burn treatment were identified, it shifted its focus towards this service. Burn patients can receive surgery, skin grafts, and have their dressings changed, and benefit from physiotherapy. The facility also treats emergency cases in its emergency room. Mental health support and outpatient consultations are also provided. In addition, MSF administers vaccines, and undertakes health education and disease surveillance activities in 180 camps hosting around 165,000 internally displaced people around Atmeh. A referral system has also been put in place by MSF to transfer patients in need of more specialized treatment to Turkey.</p>
<p>In the first half of 2016, the MSF team in Atmeh burn hospital saw over 6,000 patients in the emergency room, and performed more than 630 major surgeries. During the same period, more than 250 patients were admitted to the inpatient department, and around 240 were transferred to Turkey for further treatment. In the camps for internally displaced people, MSF teams provided more than 81,500 doses of vaccines to children under three.</p>
<h4><strong>Hasakah Governorate</strong></h4>
<p>In addition to the devastation caused by more than five years of war, the general situation in northeast Syria has deteriorated even further due to regular military confrontations between various armed groups, aggravated by more recent tensions with neighboring countries.</p>
<p>Although the border with Iraq has been closed to people crossing since March 2016, movement of populations and goods is allowed intermittently. </p>
<p>While the region has not experienced the scale of the conflict seen in other areas in Syria, there are significant medical and humanitarian needs.</p>
<p>Since 2013, MSF teams have been offering primary healthcare services through two primary health centres and a maternity clinic, with a particular focus on mother and child care, and chronic diseases. These services are available to both internally displaced people and the host community.</p>
<p>From January 1 to June 30, 2016, MSF teams provided over 24,500 general consultations, including 11,700 for chronic diseases, 4,304 for children under the age of five, and more than 3,200 reproductive health consultations. The teams also assisted an average of 170 deliveries each month. MSF is currently working on opening two additional primary health centers in the governorate.</p>
<h4><strong>Remote Support to Medical Facilities Nationwide</strong></h4>
<p>Since 2011, MSF has been supporting a growing number of medical structures in some of the most conflict-affected areas of Syria, and in areas where MSF does not have direct access to patients. A particular emphasis has been placed on supporting facilities situated in areas under siege.</p>
<p>MSF runs programs of active regular support to 70 medical structures, which vary from small rural health posts to full hospitals in urban areas. The supported structures are located throughout much of the country, including in the governorates of Deraa, Hama, Homs, Idlib, and rural Rif Damascus. Developed in close collaboration with Syrian medical networks, and mostly run from neighboring countries, the support projects run by MSF consist of donations of essential medical equipment and relief materials, distance training for staff inside Syria, support for ambulance services, as well as financial support to cover the facilities' running costs. MSF support is tailored based on needs and on the capacity of other agencies to support the health facilities inside Syria. As such, some facilities rely solely on MSF support, while others receive partial support from other agencies (either international or local). Support levels range from almost 100 percent MSF-supported through to 50 or 60 percent MSF-supported.</p>
<p>A further 80 facilities are supported in an ad hoc manner based on specific requests from the facilities, such as emergency donations of medical supplies provided at times of acute need, for example mass casualty influxes.</p>
<p>MSF's medical support program has increasingly focused on besieged areas, where the medical situation is particularly dire.</p>
<p>Many of these medical facilities have come under such consistent bombardment or shelling that their infrastructure has been catastrophically degraded. Over the past five years many medical staff have been killed or wounded, leaving a chronic shortage of well-trained personnel. The very few humanitarian convoys that have been allowed into some of these areas often have essential medical items removed before reaching their destination, further reducing the medical services that can be offered to these communities. And when patients are severely wounded or sick and need care that cannot be provided in the besieged areas, medical evacuations to properly equipped hospitals are usually denied—even the few medical evacuations that are permitted can take days or weeks to negotiate and organize.</p>
<h4><strong>East Aleppo City and Remote Support</strong></h4>
<p>MSF regularly provided drugs and supplies, including lifesaving surgical kits and medical equipment, to eight hospitals, six health centers, and three first-aid points in east Aleppo city since 2014. Additional provisions were also sent in times of emergency, when numbers of wounded or severely ill suddenly increased. MSF has also provided medical and logistical equipment to the hospitals to restart activities after airstrikes.</p>
<p>Prior to the consolidation of the siege in July 2016, MSF was able to send regular, three-month supplies of medical provisions (equivalent to 10 full trucks) to all supported health structures in east Aleppo. In late August 2016, MSF was able to deliver one last shipment of approximately 100 tons of much-needed medical supplies, after a temporary passage into east Aleppo was opened by opposition groups. MSF has been unable to deliver medical supplies since, due to the siege. The temporary ceasefire collapsed in late September, and the bombing intensified, resulting in a significant increase in the number of wounded. Civilian infrastructure was not spared, including health care facilities.</p>
<p>From November onward, access to health care in east Aleppo had become almost non-existent for the population in need. According to the medical networks that MSF supports, from September 23 to November 24, more than 4,350 people were wounded in east Aleppo, including over 510 children. It is reported that more than 1,060 people have died, including at least 150 children. These are overwhelming numbers for a two-month period and are likely an underestimate, as some families bury their dead immediately rather than bringing the bodies to hospital morgues. In the 10 days between November 15 and 24 the number of wounded people reached over 1,500, demonstrating yet again the sheer intensity of the bombings, and the impossible lifesaving task faced by east Aleppo doctors.</p>
<p>In December, the Syrian army and allied forces took control of most parts of east Aleppo city after an advance by air and ground forces. Thousands of residents fled from northern areas of east Aleppo city. On December 23, the Syrian government announced it had taken full control of Aleppo city, which had been divided between the opposition and the government since 2012.</p>
<h2><strong>MSF in Neighboring Countries</strong></h2>
<h3>Jordan</h3>
<p>Jordan is host to around 629,000 registered refugees, and a roughly equal number are estimated to be living in the country unregistered. Access to free health care for refugees living outside the camps in Jordan was stopped in October 2014, creating further difficulties. To support the health burden created by these large numbers, MSF has established a number of health projects where teams undertake surgical interventions, treat non-communicable diseases (NCDs), and provide maternal, child health, and mental health services.</p>
<h4><strong>Amman</strong></h4>
<p>The reconstructive surgery project in Amman was established in 2006 to offer orthopedic, maxillofacial, and plastic surgery, as well as physiotherapy and psychosocial support to victims of violence in the region. As the conflict in neighboring Syria escalated, the number of Syrian patients increased and more than 50 percent of the patients in the hospital are currently Syrian. In August 2015, project moved into a newly renovated structure. The move is intended to improve the quality of the medical services offered to patients. Since it opened nine years ago, the hospital has admitted more than 3,700 people and teams have conducted 8,238 surgeries.</p>
<h4><strong>Al Ramtha</strong></h4>
<p>For the last three years, the emergency surgical program inside the Al Ramtha government hospital has been offering lifesaving trauma surgery for patients injured in the Syrian conflict. Just five kilometers from the Syrian border, the project has seen more than 2,400 Syrian war-wounded patients arrive at its emergency room. Around 75 percent of patients were suffering from polytrauma resulting from blast injuries. Around 90 percent of all war-wounded patients who come across the border from Syria are initially seen in the MSF project in Al Ramtha.</p>
<p>Following the closure of the Jordan and Syria border due to a car bomb attack in an area referred to as "the Berm" in June 2016, only two war-wounded Syrians have arrived at the emergency room.</p>
<p>Turkey hosts more than a million refugees who fled the conflict in Syria. MSF was authorized in June 2015 to work with refugees from the Syrian crisis. In Kilis, a town on the southern border with Syria, the number of refugees (107,000) is higher than that of the host population (90,000). From January to August 2015, MSF provided counseling to 2,075 people and performed 22,860 outpatient department consultations. In Sanliurfa Province, MSF works in partnership with two Turkish NGOs to provide ongoing mental health services and responded to refugee influxes from Kobane and Tal Abyad with food and hygiene kit distributions, along with water and sanitation infrastructure in camps.</p>
<p></p><div class="media media-element-container media-default"><div class="media-element file-default" style="width: 600px; height: 400px;"><div class="media-image-wrapper"><img height="667" width="1000" style="width: 600px; height: 400px;" title="Salwah Mekrsh was shot by a sniper in Aleppo and now she can't walk. As a refugee in Kilis, Turkey, she is receiving psychological support from MSF." class="media-element file-default" src="https://media.msf.org/Docs/MSF/Media/TR1/b/3/d/3/MSF135353.jpg" alt="" /><div class="field field-name-field-metadata-copyright field-type-text-long field-label-hidden"><div class="field-items"><div class="field-item even">MSF/Anna Surinyach</div></div></div></div><div class="field-name-field-nmetadata-caption">Salwah Mekrsh was shot by a sniper in Aleppo and now she can't walk. As a refugee in Kilis, Turkey, she is receiving psychological support from MSF.</div>
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<p>In March 2016, MSF opened a private NCD clinic in Ramtha city, providing care to Syrian refugees and vulnerable Jordanians. Currently, 1,500 patients are under treatment: around 75 percent are Syrian and 25 percent Jordanian. The main diseases treated are hypertension, diabetes, cardiovascular disease, asthma, and chronic obstructive pulmonary disease. The clinic also offers mental health services for NCD patients, and home-based care. Health promotion activities are carried out by MSF community health workers.</p>
<h4><strong>Turra, Sahel Houran, Ramtha</strong></h4>
<p>In September 2016, MSF started offering free primary health care to Syrian refugees and vulnerable Jordanians in the comprehensive primary health care center in Turra, Sahel Houran, Ramtha. There are outpatient services, maternal health services such as ante- and postnatal care, and mental health services. Health education is also undertaken.</p>
<h4><strong>Zaatari Refugee Camp</strong></h4>
<p>MSF has a 40-bed post-operative care facility in Zaatari refugee camp, which offers post-injury treatment as well as mental health activities and physical therapy sessions. In July 2016, MSF opened a new child-friendly space within the project as part of the mental health activities provided to Syrian war-wounded children in collaboration with other international organisations. Between January and July 2016, over 620 patients received medical treatment at the facility and over 690 psychosocial support sessions were conducted.</p>
<p>After the Jordanian government closed its northwestern border with Syria on June 21, 2016, the number of war-wounded has decreased significantly as they are being denied access to Jordan. Should the situation at the borders remain unchanged, MSF fears that its ongoing programs in Jordan which address the medical needs of war-wounded Syrians could be forced to close.</p>
<h4><strong>Irbid</strong></h4>
<p>Following assessments in 2013, MSF established a maternal and child health project in Irbid, close to the border with Syria. The area is home to tens of thousands of Syrian refugees living outside the refugee camps, and these people have difficulty accessing the care they need. Needs for maternal and child care increased at the end of 2014, when Jordanian authorities announced that all Syrian refugees, whether registered or not, would have to pay for Ministry of Health services. In the first quarter of 2015, the project was upgraded to be able to manage complicated deliveries and provide Caesarean sections. An intensive care unit was also established.</p>
<p>MSF also has two clinics in Irbid Governorate treating Syrians and vulnerable Jordanians who suffer from NCDs. The first clinic, operated in partnership with the Jordanian Ministry of Health, opened in December 2014 and the second, run with the Arabian Medical Relief Society, a local NGO, opened in April 2015. In August 2015, MSF launched the home visit program—10 kilometer radius from the town center—to reach patients who can't access the two clinics due to medical conditions and/or a disability. The majority of patients in both clinics are treated for hypertension, diabetes, and asthma. By the end of July 2016, there were 4,540 patients under treatment in the two clinics. MSF also offers psychosocial support and counseling.</p>
<h4><strong>The Berm: the Syrian–Jordan Border</strong></h4>
<p>More than 75,000 Syrians are stranded between Syria and Jordan in the northeast of the country. MSF operated a mobile health clinic offering primary health care in the berm/Rukban area for 23 days starting on May 16, 2016. Services were provided in trucks, and prioritized children under five as well as pregnant women. MSF also managed referrals in collaboration with the Royal Medical Services and conducted over 3,500 consultations (more than 200 malnourished children, 10 severely; 500 pregnant women; one baby delivered; three successful emergency medical referrals). After the car bomb attack on the Jordanian border base on June 21, 2016, access to the border was stopped and humanitarian assistance was not provided beyond limited access to water and food.</p>
<p>As of November 23, UN agencies were allowed to resume their humanitarian aid to the berm. MSF welcomes the resumption of aid and hopes that it will continue to be provided in a regular and sustained manner. However, we are questioning medical aid delivery through the current set-up in the area, as the triage of medical cases should be carried out or overseen by qualified medical professionals. To this end, MSF continues to negotiate for direct access to Syrians at the berm, and reaffirms/reiterates that provision of independent quality medical care should be provided inside the berm.</p>
<blockquote><p>"I see the MSF Reconstructive Surgery Project as a very unique project. Its mission goes beyond the physical care of war victims as it aims to improve the quality of their lives as much as possible. This project provides a comprehensive package of psychological care and rehabilitation, allowing the patients to reintegrate into their societies after their treatment. Moving into a new hospital is a significant step in the life of this project. It will facilitate MSF’s mission to improve the quality of the medical services, which we will provide to patients in the coming years. This new facility will also open new horizons, allowing us to add new surgical specialties, not to mention the possibility to develop a healthy work environment and improve our disinfection policies.”</p>
<p style="text-align: right;"><strong>—Dr. Rasheed Fakhri, Surgical Coordinator</strong></p>
</blockquote>
<p></p><div class="media media-element-container media-default"><div class="media-element file-default" style="width: 600px; height: 400px;"><div class="media-image-wrapper"><img height="667" width="1000" style="width: 600px; height: 400px;" title="Young patients play together at the Amman Hospital." class="media-element file-default" src="https://media.msf.org/Docs/MSF/Media/TR1/c/2/2/7/MSF151742.jpg" alt="" /><div class="field field-name-field-metadata-copyright field-type-text-long field-label-hidden"><div class="field-items"><div class="field-item even">Ali Jarikji/MSF</div></div></div></div><div class="field-name-field-nmetadata-caption">Young patients play together at the Amman Hospital.</div>
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<h3>Lebanon</h3>
<h4><strong>Registration Problems and Deterrence </strong></h4>
<p>The situation in Lebanon remains highly volatile. The presence of over 1.4 million Syrian refugees is putting considerable strain on public services and is exacerbating tensions in the country.</p>
<p>Since December 2014, measures put in place by the government (such as costly visa requirements for Syrian refugees) have reduced the number of newcomers or registered Syrians in Lebanon, who now represent approximately 30 percent of the Lebanese population.</p>
<p>As of May 6, 2015, the UNHCR suspended new registrations of refugees in Lebanon, in line with a request by the Lebanese government. Accordingly, individuals awaiting registration are no longer included in the official figures for refugees in Lebanon. Moreover, the costly measures put in place by the Lebanese government for the renewal of documents for refugees deter Syrian refugees from doing so. Therefore, the number of non-documented refuges in Lebanon has increased.</p>
<h4><strong>Humanitarian Situation</strong></h4>
<p>Living conditions are precarious, with increasing numbers of refugees residing in informal tented settlements and unsuitable shelters. The main health concerns are access to primary and secondary health care, safe deliveries, mental health, and access to chronic disease medications.</p>
<h4><strong>Increase in MSF Medical Activities for Refugees</strong></h4>
<p>In 2015, MSF provided 305,150 primary health care consultations for Syrian refugees in Lebanon, compared to 194,427 for the whole of 2014 and 96,320 for the whole of 2013. Between January 1 and June 30, 2016, MSF provided 170,000 primary health care consultations in its clinics across Lebanon.</p>
<h4><strong>Bekaa Valley</strong></h4>
<p>In the Bekaa Valley, where the majority of refugees have settled, MSF began providing primary health care in March 2012. This continues today and includes treatment of acute illness and chronic diseases and a comprehensive reproductive health package, through four clinics in Hermel, Arsal, Baalbek, and Majdal Anjar. These services are provided for Syrian refugees irrespective of registration, as well as for vulnerable Lebanese. In addition to the reproductive health package offered in the four clinics, mental health support as well as health promotion services are also offered. MSF runs sessions specifically for women and girls, where they can consult a female doctor and/or midwife, as well as women-only sessions where women-specific health issues are discussed.</p>
<p>In February 2016, MSF opened its third mother and child center in Majdal Anjar, in central Bekaa, just a few kilometers away from the Syrian border. The center is open 24/7, and teams assist uncomplicated deliveries. The center's services are available to more than 15,000 women who otherwise have no access to free and safe delivery.</p>
<h4><strong>The North and Akkar Governorates</strong></h4>
<p>The north of Lebanon also hosts a large number of Syrians (252,450 people; UNHCR, October 2016). MSF runs five primary health care centers in the region, offering free health services to Syrian refugees and vulnerable Lebanese in Akkar and Tripoli governorates. MSF services include providing treatment for acute cases, chronic diseases, a comprehensive reproductive health package, mental health counseling, and vaccinations, in addition to health promotion activities.</p>
<p>In Tripoli, MSF has worked in Dar al-Zahraa Hospital since February 2012, providing basic health care, treatment for chronic diseases, reproductive health care, and vaccinations for Syrian refugees and vulnerable Lebanese. MSF has also been working in Al-Zahraa dispensary in Jabal Mohsen district since November 2012, and Al-Dawa dispensary in Bab al-Tabbaneh district since April 2013, providing primary health care, including treatment for acute diseases, vaccinations, and reproductive health. In Jabal Mohsen, MSF provides support during outbreaks of violence to stabilize patients before they are transferred to hospital.</p>
<p>In Akkar Governorate in April 2015, MSF opened another primary health care clinic in Abde, north of Tripoli. The clinic provides primary health care, including care for acute conditions and NCDs, as well as sexual and reproductive health care. It also offers mental health and health promotion activities, as well as vaccinations. In September 2016, MSF opened a health center in Wadi Khaled offering treatment for NCDs and mental health counseling.</p>
<h4>Palestinian Refugees from Syria</h4>
<p>Before the war began, Syria was home to approximately 500,000 Palestinian refugees, some of whom were born and raised in the country. Palestinian refugee camps inside Syria, including in Aleppo, Daraa, and the Yarmouk camp in south Damascus, have come under attack and siege, resulting in numerous fatalities and injuries. By April 2014 over 3,070 Palestinians from Syria had registered in Lebanon with UNRWA and 13,836 had sought support from UNRWA in Jordan.</p>
<p>Since June 2013, primary health care consultations have been provided at Human Call Hospital in Ein-al-Helweh camp, the largest Palestinian refugee camp in Lebanon. It is currently home to around 100,000 people.</p>
<p>In the Shatila Palestinian refugee camp, which is only 4 kilometers away from downtown Beirut, over 30,000 refugees (Syrians, Palestinians, Palestinians from Syria, and minorities) live in deplorable conditions. Since September 2013, to deal with the increasing health needs in the south Beirut area, MSF has been running a primary health center and a women's health center in Shatila. The project is intended primarily for Syrian refugees, but is open to Palestinians who have fled from Syria and other vulnerable communities living in south Beirut. The focus is on unregistered refugees who are not eligible for official assistance, or for registered refugees with emergency surgical needs that fall outside the UNHCR's shortlist of eligible injuries. The maternity unit provides care during pregnancy and simple delivery, with referrals for complicated deliveries to surrounding hospitals. Moreover, the newly expanded primary health clinic deals with postnatal care, pediatrics, and chronic diseases for adults and children. Mental health consultations are also provided in both facilities and more than 6,500 patients are seen in total at both centers each month.</p>
<p>In Burj al-Barajneh refugee camp, also located in the southern suburbs of Beirut, MSF is expanding its work by opening a new health center to provide sexual and reproductive health services, including the treatment of sexually transmitted diseases, mental health, and also to provide health promotion activities for the local population. In May 2016, the MSF health center in Burj al-Barajneh launched a home-based care program for patients with chronic diseases who suffer from mobility problems.</p>
<p></p><div class="media media-element-container media-default"><div class="media-element file-default" style="width: 600px; height: 520px;"><div class="media-image-wrapper"><img height="867" width="1000" style="width: 600px; height: 520px;" title="A post-operative care facility in Zaarari refugee camp provides physical therapy and mental health activities." class="media-element file-default" src="https://media.msf.org/Docs/MSF/Media/TR1/7/a/6/7/MSF158141.jpg" alt="" /><div class="field field-name-field-metadata-copyright field-type-text-long field-label-hidden"><div class="field-items"><div class="field-item even">Isidro Serrano Selva</div></div></div></div><div class="field-name-field-nmetadata-caption">A post-operative care facility in Zaarari refugee camp provides physical therapy and mental health activities.</div>
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<h3>Iraq</h3>
<p>The Kurdish Region hosts the vast majority of the 251,499 Syrian refugees currently in Iraq (UNHCR, July 2015), but with the current turmoil in the country the burden on the region is increasingly high. In light of the overwhelming crisis, some international humanitarian organisations are scaling down their assistance to Syrian refugees in the country. Over the past year, the spread of violence across Iraq has led some Syrian refugees to return to Syria while tens of thousands of Iraqi nationals crossed into Syria in August 2014 before crossing back into safer areas of Iraq.</p>
<h4><strong>Domiz</strong></h4>
<p>The population in Domiz refugee camp (Dohuk Governorate) has significantly reduced over the past year due to large movements of people. Today, the camp's population is estimated to be around 38,392 (UNCHR, October 2016).</p>
<p>From May 2012 to October 2015, MSF was the main provider of health services to Syrian refugees in Domiz camp, including primary health care, sexual and reproductive health care, care for chronic diseases, and mental health assistance. Since August 2014, MSF has been running a maternity unit inside the camp, and today MSF teams focus on providing sexual and reproductive healthcare through this unit. Teams assist an average of 85 deliveries per month and ensure the referral of complicated cases to Dohuk Hospital.</p>
<p>In October, after three years of activities, MSF teams handed over the general health care and mental health consultations to the local authorities. The treatment of patients with chronic diseases was handed over in June 2016 to the Department of Health.</p>
<h4><strong>Erbil</strong></h4>
<p>MSF provides mental health services in two refugee camps in Erbil Governorate—Kawargosk camp and Darashakran camp.</p>
<p></p><div class="media media-element-container media-default"><div class="media-element file-default" style="width: 600px; height: 400px;"><div class="media-image-wrapper"><img height="667" width="1000" style="width: 600px; height: 400px;" title="An MSF nurse and volunteer provide sexual and reproductive health services in Majdal Anjar clinic." class="media-element file-default" src="https://media.msf.org/Docs/MSF/Media/TR1/b/4/4/b/MSF153942.jpg" alt="" /><div class="field field-name-field-metadata-copyright field-type-text-long field-label-hidden"><div class="field-items"><div class="field-item even">Louise Annaud/MSF</div></div></div></div><div class="field-name-field-nmetadata-caption">An MSF nurse and volunteer provide sexual and reproductive health services in Majdal Anjar clinic.</div>
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<h3>Turkey</h3>
<p>Turkey hosts more than 2.5 million Syrian refugees. In Kilis, MSF is working in partnership with Citizens' Assembly to provide primary healthcare and mental health psychosocial support for Syrian refugees. Between 1 January and 31 August, the primary health care component of the project provided 21,153 outpatient consultations. In the mental health programme, 2,648 individual psychological sessions were conducted, and 1,804 group counselling or home visit sessions with undertaken by trained community health workers.</p>
<p>In Sanliurfa province, MSF works in partnership with two Turkish NGOs (Support to Life and International Blue Crescent Foundation) to provide mental health services. Through this partnership, assistance is also provided to refugees arriving from Kobane and Tal Abyad, with food and hygiene kit distributions, and improvement of water and sanitation infrastructure in the camps.</p>
<p>MSF worked in Akcakale transit camp from November 2015 until it closed in May 2016. The Akcakale camp was hosting 4,000 refugees, and approximately 300 were voluntarily relocated to other camps while the rest preferred to live outside. MSF distributed hygiene kits to those who decided to live outside camps in the outskirts of Akcakale town.</p>
<p>MSF is providing financial and technical support to partner agency Hayata Destek (Support to Life) in Şanlıurfa province. A program to provide mental healthcare and psychosocial support to Syrian refugees in Şanlıurfa is ongoing. MSF also provides financial and technical support to International Blue Crescent Relief and Development Foundation to support their provision of mental healthcare and psychosocial support activities for Syrian refugees through a community centre in Akçakale. </p>
<p>In Gaziantep, the Voluntary Health Center for People under Temporary Protection opened in December 2015 co-lead by MSF and Physicians Across Continents. The centre provides sexual and reproductive healthcare and outpatient consultations to women and children. The MSF-run sexual and reproductive healthcare activities at the clinic ceased in April 2016, but MSF continues to provide consultations to its patients by supporting the Primary Health Care Association, a Syrian medical facility based in Gaziantep.</p>
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</div></div></div></div></div>Thu, 26 Dec 2013 13:46:38 +0000Artem Kolotilkin51151 at https://www.doctorswithoutborders.orghttps://www.doctorswithoutborders.org/country-region/syria#commentsSwitzerland (Closed)https://www.doctorswithoutborders.org/country-region/switzerland-closed
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<div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even"><p><em><strong>MSF closed its projects in Switzerland in 2009.</strong></em></p>
<ul></ul><h4>Why were we there?</h4>
<ul><li>Health care exclusion</li>
</ul><h4>Historical</h4>
<p><em>This is an excerpt from MSF's <a href="http://www.doctorswithoutborders.org/news-stories/international-activity-report/activity-report-2011">2011 International Activity Report</a>:</em></p>
<p><strong>Undocumented migrants have great difficulty accessing health care in Switzerland. Although officially the Swiss Constitution guarantees access to the health system for all, thousands of people, often due to their lack of health insurance or their fear of being reported and expelled from the country, are left without proper medical care. </strong></p>
<p>In January 2006, Doctors Without Borders/Médecins Sans Frontières (MSF) set up a project called Meditrina, which provided free medical consultations for these people. In January 2010, the Swiss Red Cross took over this project.</p>
<p>Located in a small alley of downtown Zurich, the MSF Meditrina clinic provided more than 1,100 free consultations in 2009, bringing the total since the beginning of the project in 2006 to more than 3,400. Furthermore, hundreds of patients were referred to a network of medical and paramedical specialists who provided confidential consultations and medical care.</p>
<p>Around 50 percent of Meditrina’s patients are migrants living without documents in the Zurich area, but many others, despite their legitimate status, came to the MSF clinic because they could not or did not know how to access public health care.</p>
<p>The most common conditions found in patients at the Meditrina clinic were gastrointestinal, dental, and dermatological. Many patients also showed psychological disorders, often linked to their difficult living conditions. Meditrina also provided testing, counseling, and long-term treatment for chronic diseases such as <a href="http://www.doctorswithoutborders.org/our-work/medical-issues/hivaids">HIV/AIDS</a> and <a href="http://www.doctorswithoutborders.org/our-work/medical-issues/tuberculosis">tuberculosis</a>.</p>
<p>After setting up and establishing Meditrina as a reliable and functioning entry point to the Swiss health care system for Zurich’s undocumented people, MSF looked for an organization to take over the project long term. The Zurich branch of the Swiss Red Cross, already involved in providing care to those who need it most, took over the project at the beginning of 2010.</p>
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</div></div></div>Thu, 26 Dec 2013 13:28:21 +0000Artem Kolotilkin51146 at https://www.doctorswithoutborders.orghttps://www.doctorswithoutborders.org/country-region/switzerland-closed#commentsSwazilandhttps://www.doctorswithoutborders.org/country-region/swaziland
<div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even"><h2>Swaziland: Latest MSF Updates</h2>
<ul><li><a href="http://www.doctorswithoutborders.org/article/tb-patient-uses-sign-language-swaziland">TB Patient Uses Sign Language in Swaziland</a></li>
<li><a href="http://www.doctorswithoutborders.org/article/swaziland-new-hope-drug-resistant-tb-patients">Swaziland: New Hope for Drug-Resistant TB Patients</a></li>
<li><a href="http://www.doctorswithoutborders.org/article/multi-drug-resistant-tb-strain-swaziland-not-detectable-most-advanced-rapid-diagnostic-tests">Multi-drug Resistant TB Strain in Swaziland Not Detectable by Most Advanced Rapid Diagnostic Tests</a></li>
<li><a href="http://www.doctorswithoutborders.org/news-stories/voice-field/surviving-drug-resistant-tb-swaziland">Surviving Drug-Resistant TB in Swaziland</a></li>
</ul><p> </p>
<p></p><div class="media-element file-default" style=" width: 1756px;"><div class="media-image-wrapper"><img height="1527" width="1756" class="media-element file-default" style=" width: 1756px;" src="/sites/usa/files/map_swaziland_2016.jpg" alt="" title="" /></div></div>
<p><em>This information is excerpted from MSF’s 2016 </em><em><em><a href="http://www.msf.org/sites/msf.org/files/msf_activity_report_2016_web.pdf">International Activity Report</a>.</em></em></p>
<p>MSF continued to get more HIV patients on antiretroviral (ARV) treatment in 2016 through the “test and start” strategy. MSF piloted the strategy in the Nhlangano project, where, after HIV testing, ARVs were immediately offered to more than 1,700 people who tested positive. Twelve months after treatment initiation, 82 percent of patients had successfully suppressed the virus. As a result, “test and start” was adopted by the Ministry of Health (MOH) as the national standard of HIV care in October.</p>
<p>MSF increasingly focused on providing specialized HIV care, including second- and third-line ARV treatment, cervical cancer screening, and routine point-of-care testing for opportunistic infections. In 2016, 31,784 patients had viral load tests, 407 received second-line HIV care, 1,407 were enrolled in community ARV models of care, and 647 women were screened for cervical cancer (of whom 19 percent tested positive).</p>
<p>In Moneni, MSF started treating patients with extensively drug-resistant TB (XDR-TB) using the promising new drugs bedaquiline and delamanid in combination with repurposed medicines. After six months, almost all of the 81 XDR-TB and multi drug-resistant TB (MDR-TB) patients had reached the stage where TB bacteria could no longer be detected in their sputum. In Manzini, MSF saw a success rate of 75 percent when implementing the shorter DR-TB treatment regimen of nine to 12 months, rather than two years. This regimen has since been recommended by the World Health Organization and was adopted by the MOH as the new national standard of care for MDR-TB treatment, with support from MSF.</p>
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<div class="field field-name-field-media-summary-image field-type-image field-label-above"><div class="field-label">Image:&nbsp;</div><div class="field-items"><div class="field-item even"><img src="http://media.msf.org/Docs/MSF/Media/TR1/7/b/d/4/MSF17747.jpg" width="1000" height="666" /></div></div></div><div class="field field-name-field-nmetadata-country field-type-text field-label-above"><div class="field-label">Country:&nbsp;</div><div class="field-items"><div class="field-item even">Swaziland</div></div></div><div class="field field-name-field-nmetadata-caption field-type-text-long field-label-above"><div class="field-label">Caption:&nbsp;</div><div class="field-items"><div class="field-item even"><p>MSF staff prepares a daily injection for an MDR-TB patient at her home in the Mhlabeni area of Swaziland.</p>
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</div></div></div></div></div>Thu, 26 Dec 2013 13:07:39 +0000Artem Kolotilkin51141 at https://www.doctorswithoutborders.orghttps://www.doctorswithoutborders.org/country-region/swaziland#commentsSudanhttps://www.doctorswithoutborders.org/country-region/sudan
<div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even"><h2>Sudan: Latest MSF Updates</h2>
<ul><li><a href="https://www.doctorswithoutborders.org/article/sudan-violence-never-far-away-people-stranded-north-darfurs-sortoni-camp">Sudan: "Violence is never far away" for People Stranded in North Darfur's Sortoni Camp</a></li>
<li><a href="https://www.doctorswithoutborders.org/article/sudan-providing-medical-care-south-sudanese-refugees-white-nile-state">Sudan: Providing Medical Care to South Sudanese Refugees in White Nile State</a></li>
<li><a href="https://www.doctorswithoutborders.org/article/north-darfur-61000-people-living-precarious-conditions-sortoni-camp">North Darfur: 61,000 People Living in Precarious Conditions in Sortoni Camp</a></li>
<li><a href="https://www.doctorswithoutborders.org/article/darfur-thousands-flee-fighting-jebel-marra">Darfur: Thousands Flee FIghting in Jebel Marra</a></li>
</ul><h2><div class="media-element file-default" style="font-size: 12px;"><div class="media-image-wrapper"><img height="1318" width="1494" style="font-size: 12px;" class="media-element file-default" src="/sites/usa/files/map_sudan_2016.jpg" alt="" title="" /></div></div></h2>
<p><em>This information is excerpted from MSF’s 2016 </em><em><em><a href="http://www.msf.org/sites/msf.org/files/msf_activity_report_2016_web.pdf">International Activity Report</a>.</em></em></p>
<p>MSF continued to provide emergency medical treatment in Sudan despite some restrictions to areas affected by conflict.</p>
<p>When fighting displaced more than 160,000 people from Jebel Mara, North Darfur, MSF deployed an emergency response team to set up a health center in Sortoni and increase operations in Tawila. In Sortoni, MSF treated 40,616 outpatients and vaccinated 9,683 children for measles. In Tawila, MSF conducted 108,933 outpatient consultations and admitted 4,878 inpatients—mainly for malnutrition, diarrheal diseases, and malaria.</p>
<p>MSF responded to violence in the gold mining area of El Sireaf and ran four health centers in Dar Zaghawa focused on mothers and children.</p>
<p>In El Geneina town, West Darfur state, MSF teams supported three primary health centers and helped the government hospital manage severely malnourished children.</p>
<p>MSF ran a 40-bed hospital outside Kashafa camp in White Nile State, serving the more than 17,000 refugees from South Sudan, acting as a referral facility for five other camps, and providing care for the host community.</p>
<p>In the village of Tabarak Allah, in Al-Gedaref state, MSF screened 2,180 people for kala azar (visceral leishmaniasis) and admitted 545 kala azar patients to Tabarak Allah government rural hospital. MSF started supporting Bazura hospital where kala azar is endemic. MSF trained Ministry of Health staff and ran health education and awareness-raising activities for the Tabarak Allah and Bazura communities in partnership with a local NGO.</p>
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<label>Language </label>
English
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<div class="field field-name-field-taxonomy-issues field-type-taxonomy-term-reference field-label-above"><div class="field-label">Issues:&nbsp;</div><div class="field-items"><div class="field-item even"><a href="/issues/war">War</a></div><div class="field-item odd"><a href="/issues/forced-displacement">Forced Displacement</a></div><div class="field-item even"><a href="/issues/refugee">Refugee</a></div><div class="field-item odd"><a href="/issues/internally-displaced-person">Internally Displaced Person</a></div></div></div><div class="field field-name-field-taxonomy-region field-type-taxonomy-term-reference field-label-above"><div class="field-label">Country / Region:&nbsp;</div><div class="field-items"><div class="field-item even"><a href="/countryregion/sudan">Sudan</a></div></div></div><div class="field field-name-field-getlocation field-type-getlocations-fields field-label-above"><div class="field-label">Location:&nbsp;</div><div class="field-items"><div class="field-item even"><div class="location vcard"><div class="adr"><div class="country-name">Sudan</div></div></div><div class="getlocations_map_wrapper_inner"><div id="getlocations_map_wrapper_key_4" style="width: 500PX; height: 400PX" ><div class="getlocations_map_canvas" id="getlocations_map_canvas_key_4" style="width: 100%; height: 100%" ></div></div></div>
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<!--//--><![CDATA[//><!--
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</div></div></div><div class="field-collection-container clearfix"><div class="field field-name-field-image field-type-field-collection field-label-above"><div class="field-label">Photos:&nbsp;</div><div class="field-items"><div class="field-item even"><div class="field-collection-view clearfix view-mode-full field-collection-view-final"><div class="ds-1col entity entity-field-collection-item field-collection-item-field-image view-mode-full clearfix">
<div class="field field-name-field-media-image field-type-image field-label-hidden"><div class="field-items"><div class="field-item even"><img src="http://media.msf.org/Docs/MSF/Media/TR1/b/a/0/2/MSF16248.jpg" width="1000" height="667" alt="Darfur" /></div></div></div></div>
</div></div></div></div></div><div class="field-collection-container clearfix"><div class="field field-name-field-summary-image field-type-field-collection field-label-above"><div class="field-label">Summary image:&nbsp;</div><div class="field-items"><div class="field-item even"><div class="field-collection-view clearfix view-mode-full field-collection-view-final"><div class="entity entity-field-collection-item field-collection-item-field-summary-image clearfix">
<div class="content">
<div class="field field-name-field-media-summary-image field-type-image field-label-above"><div class="field-label">Image:&nbsp;</div><div class="field-items"><div class="field-item even"><img src="http://media.msf.org/Docs/MSF/Media/TR1/4/f/1/4/MSF117105.jpg" width="1000" height="750" alt="Kaguro" /></div></div></div><div class="field field-name-field-nmetadata-alt field-type-text field-label-above"><div class="field-label">Alt:&nbsp;</div><div class="field-items"><div class="field-item even">Kaguro</div></div></div><div class="field field-name-field-nmetadata-country field-type-text field-label-above"><div class="field-label">Country:&nbsp;</div><div class="field-items"><div class="field-item even">Sudan</div></div></div><div class="field field-name-field-nmetadata-title field-type-text field-label-above"><div class="field-label">Title:&nbsp;</div><div class="field-items"><div class="field-item even">Kaguro</div></div></div><div class="field field-name-field-nmetadata-ost field-type-text field-label-above"><div class="field-label">Original submission title:&nbsp;</div><div class="field-items"><div class="field-item even">Kaguro, May 2012</div></div></div><div class="field field-name-field-nmetadata-caption field-type-text-long field-label-above"><div class="field-label">Caption:&nbsp;</div><div class="field-items"><div class="field-item even"><p>MSF began providing medical assistance in the Jebel Si area of Darfur in 2005.</p>
</div></div></div> </div>
</div>
</div></div></div></div></div>Thu, 26 Dec 2013 13:00:10 +0000Artem Kolotilkin51136 at https://www.doctorswithoutborders.orghttps://www.doctorswithoutborders.org/country-region/sudan#commentsSri Lanka (Closed)https://www.doctorswithoutborders.org/country-region/sri-lanka-closed
<div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even"><p><em><strong>MSF closed its projects in Sri Lanka in 2012.</strong></em></p>
<h4>Why were we there?</h4>
<ul><li>Post-armed conflict rehabilitation</li>
</ul><p></p><div class="media-element file-default" style="width: 600px; height: 399px;"><div class="media-image-wrapper"><img height="416" width="626" style="width: 600px; height: 399px;" class="media-element file-default" src="/sites/usa/files/sri_lanka_map_2012.jpg" alt="" title="" /></div></div>
<h4>Historical</h4>
<p><em>This is an excerpt from MSF's <a href="https://www.doctorswithoutborders.org/news-stories/international-activity-report/activity-report-2012">2012 International Activity Report</a>:</em></p>
<h3>2012</h3>
<p><strong>T</strong><strong>hree years after the devastating civil war ended, Doctors Without Borders/Médecins Sans Frontières (MSF) handed over its last remaining activities in </strong><strong>Sri Lanka. </strong></p>
<p>In Mullaitivu Hospital, a team had been assisting in the provision of emergency care, surgery, and gynecological and obstetric services.</p>
<p>Staff also held weekly mobile clinics at five sites, providing access to health services for isolated communities. These activities came to an end in June.</p>
<h3>Mental Health Services Handed Over</h3>
<p>Physical scars may have healed, but the <a href="/our-work/medical-issues/mental-health">mental health</a> of those traumatized by war and distressed by resettlement still needs to be addressed. <a href="/work-with-us/work-in-the-field/who-we-need">MSF mental health staff</a> worked at the main district hospitals in Mullaitivu and Kilinochchi as well as at other sites in the districts. Mobile teams traveled to more distant villages to offer care to people unable to travel.</p>
<p>MSF also developed community-based psychosocial services in schools. Before leaving Kilinochchi, staff provided training to 10 psychological support officers and 10 field assistants.</p>
<p>The Ministry of Health has committed to continuing the development of community-based psychosocial services. In late 2011, the ministry and the Sri Lanka College of Psychiatrists launched a media campaign to raise awareness of mental health issues and to increase access to expert medical care.</p>
<p>MSF’s program in Mullaitivu has been handed over to international non-governmental organization World Vision, which has a long-term operational plan for the north of the country, while a local organization has taken on activities in Kilinochchi.</p>
<p><em><strong>At the end of 2012, MSF had 73 staff in Sri Lanka. MSF first worked in the country in 1986.</strong></em></p>
</div></div></div><div class="form-item form-type-item">
<label>Language </label>
English
</div>
<div class="field field-name-field-taxonomy-issues field-type-taxonomy-term-reference field-label-above"><div class="field-label">Issues:&nbsp;</div><div class="field-items"><div class="field-item even"><a href="/issues/war">War</a></div><div class="field-item odd"><a href="/issues/forced-displacement">Forced Displacement</a></div><div class="field-item even"><a href="/issues/armed-conflict">Armed Conflict</a></div><div class="field-item odd"><a href="/issues/civil-war">Civil War</a></div><div class="field-item even"><a href="/issues/post-conflict">Post-conflict</a></div></div></div><div class="field field-name-field-taxonomy-region field-type-taxonomy-term-reference field-label-above"><div class="field-label">Country / Region:&nbsp;</div><div class="field-items"><div class="field-item even"><a href="/countryregion/sri-lanka">Sri Lanka</a></div></div></div><div class="field field-name-field-getlocation field-type-getlocations-fields field-label-above"><div class="field-label">Location:&nbsp;</div><div class="field-items"><div class="field-item even"><div class="location vcard"><div class="adr"><div class="country-name">Sri Lanka</div></div></div><div class="getlocations_map_wrapper_inner"><div id="getlocations_map_wrapper_key_5" style="width: 500PX; height: 400PX" ><div class="getlocations_map_canvas" id="getlocations_map_canvas_key_5" style="width: 100%; height: 100%" ></div></div></div>
<script type="text/javascript">
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</script>
</div></div></div><div class="field-collection-container clearfix"><div class="field field-name-field-image field-type-field-collection field-label-above"><div class="field-label">Photos:&nbsp;</div><div class="field-items"><div class="field-item even"><div class="field-collection-view clearfix view-mode-full field-collection-view-final"><div class="ds-1col entity entity-field-collection-item field-collection-item-field-image view-mode-full clearfix">
<div class="field field-name-field-media-image field-type-image field-label-hidden"><div class="field-items"><div class="field-item even"><img src="http://media.msf.org/Docs/MSF/Media/TR1/f/9/2/a/MSF11453.jpg" width="1000" height="665" /></div></div></div></div>
</div></div></div></div></div><div class="field-collection-container clearfix"><div class="field field-name-field-summary-image field-type-field-collection field-label-above"><div class="field-label">Summary image:&nbsp;</div><div class="field-items"><div class="field-item even"><div class="field-collection-view clearfix view-mode-full field-collection-view-final"><div class="entity entity-field-collection-item field-collection-item-field-summary-image clearfix">
<div class="content">
<div class="field field-name-field-media-summary-image field-type-image field-label-above"><div class="field-label">Image:&nbsp;</div><div class="field-items"><div class="field-item even"><img src="http://media.msf.org/Docs/MSF/Media/TR1/f/9/2/a/MSF11453.jpg" width="1000" height="665" /></div></div></div><div class="field field-name-field-nmetadata-country field-type-text field-label-above"><div class="field-label">Country:&nbsp;</div><div class="field-items"><div class="field-item even">Sri Lanka</div></div></div><div class="field field-name-field-nmetadata-caption field-type-text-long field-label-above"><div class="field-label">Caption:&nbsp;</div><div class="field-items"><div class="field-item even"><p>An MSF physiotherapist works a patient in Pompamadhu Hospital, where MSF ran a rehabilitation program for people with spinal injuries.</p>
</div></div></div> </div>
</div>
</div></div></div></div></div>Thu, 26 Dec 2013 12:54:34 +0000Artem Kolotilkin51131 at https://www.doctorswithoutborders.orghttps://www.doctorswithoutborders.org/country-region/sri-lanka-closed#commentsSouth Sudanhttps://www.doctorswithoutborders.org/country-region/south-sudan
<div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even"><h2>South Sudan: Latest MSF Updates</h2>
<ul><li><a href="https://www.doctorswithoutborders.org/article/preventive-oral-cholera-vaccination-campaign-underway-juba-south-sudan">Preventive Oral Cholera Vaccination Campaign Underway in Juba, South Sudan</a></li>
<li><a href="https://www.doctorswithoutborders.org/article/south-sudan-treating-hiv-positive-people-affected-conflict">South Sudan: Treating HIV-Positive People Affected by Conflict</a></li>
<li><a href="/node/71926">South Sudan: Endless Cycles of Displacement Continue Along the Northern Frontier</a></li>
<li><a href="https://www.doctorswithoutborders.org/article/south-sudan-growing-risk-malaria-rains-begin" target="_blank">South Sudan: Growing Risk of Malaria as Rains Begin</a></li>
</ul><p></p><div class="media-element file-default" style=" width: 2324px;"><div class="media-image-wrapper"><img height="1556" width="2324" class="media-element file-default" style=" width: 2324px;" src="/sites/usa/files/map_south_sudan_2016.jpg" alt="" title="" /></div></div>
<p><em>This information is excerpted from MSF’s 2016 </em><em><em><a href="http://www.msf.org/sites/msf.org/files/msf_activity_report_2016_web.pdf">International Activity Report</a>.</em></em></p>
<p>More than three years of ongoing conflict, which has included extreme violence against civilians, has forced millions of people across South Sudan to flee from their homes. MSF continued to respond to urgent medical needs and maintained essential programs across the country despite growing challenges, including attacks on health care facilities. </p>
<p>In February 2016, the MSF-run hospital at the Malakal Protection of Civilians (PoC) site was attacked, and more than 25 people were killed, including two staff members. MSF published a report on the events and launched an international advocacy campaign calling on the United Nations Mission in South Sudan to provide credible security to civilians under its care and improve conditions at the site. In June, MSF completed a new 60-bed hospital on the site to replace the existing structure and opened a medical center in Malakal town.</p>
<p>After fighting broke out in July 2016 in the capital, Juba, MSF set up a surgical facility and ran mobile clinics across the city. In the first month, one outreach team treated 9,242 people. MSF staff also helped the Ministry of Health (MOH) set up and run a cholera treatment center.</p>
<p>In Greater Upper Nile Region<strong>, </strong>the MSF clinic in Pibor provided maternity and emergency services. Looting in February 2016 temporarily halted activities, but the clinic was operational again by April. The team started to offer surgery at the end of the year. MSF staff provided medical care to the 50,000 Sudanese refugees in Doro camp and the local community in Maban county.</p>
<p>The MSF hospital in Lankien, the only functioning medical facility in the area, admitted 1,068 patients to its therapeutic feeding program in 2016. Teams also provided treatment to 1,530 patients for kala azar (visceral leishmaniasis), a potentially fatal disease spread by sandflies. Malaria was the main morbidity at the hospital and in the primary health care center in Yuai; teams carried out 116,944 consultations.</p>
<p>MSF ran a 160-bed facility at the Bentiu PoC site, where 120,000 displaced civilians took shelter at the end of 2016. It was the only hospital on site, providing a range of services and running outreach activities in the POC and Bentiu town.</p>
<p>MSF set up emergency services in Leer and Mayendit counties as intense fighting displaced thousands of people, mostly into nearby swamps. Mobile teams provided care and treatment for survivors of sexual violence. In July, medical activities were temporarily disrupted when the MSF compound in Leer town was looted. In Yida, MSF offered inpatient and outpatient services, vaccinations, and HIV and TB treatment to refugees from South Kordofan, Sudan. MSF also ran facilities in Mayom county, Wau Shilluk, and Fangak.</p>
<p>In Equatoria Region, following an increase in violence, MSF set up a clinic in Yei. An MSF project set up in Mundri was suspended after an armed robbery. Despite clashes in the Yambio area, MSF continued its HIV program.</p>
<p>Aweil hospital, the only secondary health care facility in this area of Bahr El Ghazal region, served 1.5 million people. In 2016, the team provided maternal and child care and responded to a sharp peak in malaria. Further south, in Wau, MSF carried out around 42,000 consultations when violent clashes displaced more than 60,000 people in June.</p>
<p>Agok hospital provided specialist and emergency care to more than 140,000 people in the remote Abyei Special Administrative Area. Teams carried out around 50,000 consultations and treated more than 40,000 people for malaria in isolated villages.</p>
<h3>Renewed Fighting in Former Upper Nile Resulted in Multiple Displacements and Humanitarian Crisis</h3>
<p>Continued fighting over the past three months has forced 30,000 people to flee from Wau Shilluk and later from Kodok northward toward Aburoc, and toward refugee camps across the border in Sudan. Desperate living conditions and a pattern of violence in which territory rapidly changes hands has left civilians with few places to turn to for safety. Multiple displacements and lack of adequate food, clean water, and shelter have left the population vulnerable to malnutrition, dehydration, diarrhoea, and exhaustion.</p>
<p>In late April, close to 25,000 people were displaced when fighting erupted between the South Sudan People’s Liberation Army (SPLA) and Agwelek forces around the town of Kodok. Médecins Sans Frontières/Doctors Without Borders (MSF) was forced to temporarily suspend operations of two mobile units and a field hospital in the area. Other humanitarian actors also suspended operations.</p>
<p>MSF called on parties to the conflict to protect civilians and ensure their access to essential humanitarian services. The organisation’s staff traveling with the displaced population carried with them essential medicines and supplies, allowing them to provide basic treatment in the field.</p>
<p>The spreading violence and dire living conditions in Aburoc resulted in a second wave of displacement in May. Thousands of Aburoc’s internally displaced persons (IDP) fled for Sudan, where camps along the border have become increasing overcrowded. MSF is providing primary and secondary medical care at a field hospital in the area.</p>
<p>Both staying and leaving involve risk. Those remaining in Aburoc are almost entirely reliant on humanitarian assistance for their basic survival. With the rainy season at hand, transport of additional humanitarian aid to the area has become impossible. Lack of safe drinking water is a major concern that has led to numerous cases of diarrhoea. Food, shelter, and hygiene are also in short supply. In May and June MSF responded to a cholera outbreak in Aburoc and vaccinated over 11,000 people against cholera.</p>
<p>The journey northward toward Sudan is also fraught with risk. The 250-kilometre route by truck or by foot, offers little opportunity for food and water. Those who survive the journey are often suffering from dehydration, diarrhoea and malnutrition. Upon arrival, they find Sudan’s camps overcrowded and with limited supplies of water, sanitation, shelter, and non-food items. MSF manages a hospital in Sudan’s White Nile State, and since the beginning of the current emergency, has deployed an additional team of 30 medical staff to Khor Waral in order to support Sudanese authorities.</p>
<h3>Thousands at Risk of Cholera and Malnutrition in Pieri</h3>
<p>MSF teams continue to respond to the needs of displaced communities who have settled in villages around Pieri after having fled fighting which started in February. Many arrived with few belongings, living under trees as their only source of shelter. The dire living conditions have severely increased health risks, yet access to drugs and other medical supplies is limited as transport to the region becomes difficult with the arrival of the rainy season.</p>
<p>Poor hygiene and lack of safe drinking water have left many children sick, and cholera has become a major source of concern among the population. Beginning in May, MSF observed an increasing number of suspected cholera cases. MSF teams working in three areas are providing essential medical care and working to raise awareness on safe hygiene practices to combat the cholera outbreak. A cholera treatment unit has been set up in Pieri. MSF has also set up oral rehydration points in seven locations, including Pieri, Pathay and Modit.</p>
<p>Malnutrition is also a rising concern. In search of food and water, many people regularly make the four-hour walk to Pieri to collect humanitarian distributions for themselves and their families. These are often insufficient to feed an entire family, and many resort to eating tree leaves to supplement whatever food they can find. In June, one third (33%) of all children that attended our clinics were malnourished; 20% of the children screened were moderately malnourished and 13% were severely malnourished. In June and July, a total of 324 children from Pieri and around have been treated for severe acute malnutrition.</p>
<h3>MSF Celebrates World Blood Donor Day</h3>
<p>In celebration of World Blood Donor Day on June 13th, MSF organised several activities throughout South Sudan and Abyei Special Administrative Area to encourage blood donations. In Agok, where MSF has maintained a blood bank since 2015, events included a football competition and a show by traditional dancers.</p>
<p>The activities marked an important occasion for MSF to highlight how blood donations can help save lives and provide assistance to those in need. Blood banks in the country often run low and patients who urgently require transfusions cannot receive them, especially during peak malaria season. MSF staff therefore raised awareness about the process of giving blood by explaining that it is free, voluntary, and that the only requirement is that people be in good health. After the events, those who were willing to give blood were referred to hospitals where they could then have their blood taken.</p>
<p>MSF health promoters will continue to encourage blood donations for the remainder of the year at hospitals, health care centres, villages, and markets throughout South Sudan and Abyei Special Administrative Area.</p>
<h3>MSF Operations in Response to the Medical Needs in South Sudan</h3>
<p>MSF condemned the <a href="https://www.doctorswithoutborders.org/article/msf-condemns-attack-protection-civilians-site-malakal-south-sudan">outrageous violence</a> in the Malakal Protec­tion of Civilians (PoC) site on February 17 and 18, 2016, which claimed the lives of 19 people, including two MSF staff. The violence left humanitarian facilities destroyed and thousands of civilian shelters burned to the ground. The population of 47,000 who were sheltering in the camp at the time of the attack had already suffered through two years of conflict and displacement and were living in inhumane and overcrowded conditions. With large sections of the camp now destroyed, protection of civilians and a sustained humanitarian effort is required to provide basic life-saving services to the affected population. MSF strongly condemns the attack, which is yet another instance of brutality in a conflict marked by utter lack of respect for the lives and dignity of civilians. At the same time, MSF calls on all armed actors to respect the provision of medical assistance to vulnerable populations in the wake of the unacceptable looting and ransacking of its medical center in Pibor. Thousands of residents fled to the bush to escape the violence with no access to assistance. In this moment of immense medical need, MSF has launched an urgent response, but its capacity to respond to medical needs in Pibor, Lekuangole, and Gumuruk has been severely diminished as a result of this unacceptable looting.</p>
<h3>MSF Condemns Outrageous Attack in UN Protection Site in Malakal</h3>
<p>Two MSF staff were among 19 people killed during <a href="http://www.doctorswithoutborders.org/article/south-sudan-msf-treats-73-wounded-malakal-fighting">brazen and unacceptable violence</a> in the PoC site in Malakal on February 17 and 18. At least one of the two MSF staff died while attempting to assist the wounded. In total, MSF treated 108 people injured in the fighting, 46 of whom suffered from gunshot wounds. MSF has received further reports that other people who tried to put out fires or help the wounded were targeted and shot. Large sections of the camp were destroyed, including medical and humanitarian services, as well as thousands of civilian shelters. MSF had warned previously that living conditions in the camp had already been overcrowded and jeopardized the health of the population due to poor hygiene, sanitation, and access to water. This was of particular concern as the 47,000 people seeking protection in the camp were already extremely vulnerable, having endured two years of displacement, conflict, violence against civilians, and destruction of their properties and livelihoods. Now, the population confronts yet another, far more severe humanitarian crisis.</p>
<p>In the wake of the destruction in the PoC, thousands of people are living in dire conditions, in sections of the camp not designed for human habitation and without adequate access to hygiene, sanitation, or shelter. The MSF hospital provides the bulk of the secondary health care available to the population. Teams are already seeing increased numbers of patients admitted for respiratory tract infections and diarrhea, illnesses which are associated with poor living conditions. A further 5,000 displaced people are now living in Malakal town, where MSF has begun to provide mobile clinics to provide basic primary health care to the population. Protection of the population, which continues to fear for its security, must be assured and the humanitarian response in the immediate aftermath of this tragedy must be sustained to improve the conditions of the population and prevent outbreaks of disease.</p>
<p></p><div class="media media-element-container media-default"><div class="media-element file-default" style="width: 600px; height: 450px;"><div class="media-image-wrapper"><img height="750" width="1000" style="width: 600px; height: 450px;" title="Aftermath of fighting in Malakal." class="media-element file-default" src="https://media.msf.org/Docs/MSF/Media/TR1/4/b/4/5/MSF161763.jpg" alt="" /><div class="field field-name-field-metadata-copyright field-type-text-long field-label-hidden"><div class="field-items"><div class="field-item even">MSF</div></div></div></div><div class="field-name-field-nmetadata-caption">Aftermath of fighting in Malakal.</div>
</div></div>
<h3>MSF Launches Urgent Medical Response in Pibor</h3>
<p>After being forced to evacuate from the MSF compound amid heavy fighting in Pibor from February 23 to 25, MSF has resumed minimal medical operations in its looted facility in response to urgent medical needs. Amid intense fighting, the MSF team was forced to evacuate to the UN base due to the imminent possibility of being caught in the crossfire between armed groups. In the immediate aftermath, the medical team supported treatment of 36 wounded patients, including one six-year-old child suffering from a gunshot wound who died because it was impossible to provide the intensive care treatment needed. The team established a medical clinic and temporary hospitalization ward in the UN base, where 2,000 people are seeking shelter in substandard conditions, and almost two thirds of MSF’s patients are children under five years old suffering from malaria, respiratory tract infections, or diarrhea.</p>
<p>In Pibor town, the MSF medical center was thoroughly looted in the wake of the fighting. Medical equipment, fuel, patients’ beds, life-saving medicines, and therapeutic food used for treating malnourished children have all been stolen. MSF recently relocated back from the UN base to the MSF compound, where medical teams have resumed limited medical services. Thousands of people fled to the bush amid the recent fighting, where they have no access to medical assistance. MSF completed an assessment mission to Verthet, where teams treated three patients and encountered significant unmet health needs. However, the unacceptable looting of MSF’s medical center has greatly reduced its capacity to respond to present needs or to sustain its programs in Pibor, Lekuangole, and Gumuruk at the level and scale that was previously provided. MSF strongly condemns this unacceptable attack on the provision of medical assistance. The situation on the ground remains tense and MSF demands that all armed actors respect the provision of health care.</p>
<h3>Responding to Urgent Needs in Leer and Mayendit Counties</h3>
<p>MSF is providing urgent medical assistance to vulnerable, conflict-affected populations in Leer and Mayendit counties with clinics in Leer Hospital and Thonyor as well as mobile medical and nutritional clinics. The population is this region has been heavily affected by conflict, including long-term displacement, destruction of shelters, and livelihoods. With the return of other humanitarian actors in 2016, MSF is beginning to finally see the number of children admitted in its therapeutic feeding programs decreasing. However, the population remains highly food insecure and dependent on humanitarian assistance for survival. A sustained humanitarian presence is urgently needed to prevent deterioration in the health of this extremely vulnerable population.</p>
<p>Other urgent medical needs MSF is addressing in the region are high levels of acute watery diarrhea, skin and eye infections, and respiratory tract infections; all of which are associated with the deplorable conditions in which people have been living while fleeing from conflict. The rainy season will begin in the coming months, along with accompanying annual outbreaks in life-threatening disease, which will increase the medical needs. MSF has been looted three times in Leer since conflict began. As a result of repeated lootings, MSF’s capacity to provide medical assistance is greatly reduced from the scope and quality of services it was able to provide before the conflict began.</p>
<h3>Juba</h3>
<p>To escape the violence in Juba, tens of thousands of people sought refuge in UN compounds, where Protection of Civilians (PoC) sites were designated. MSF set up medical facilities in the Tomping and Juba House PoC sites, but spoke out about the deplorable living conditions there, and in other PoC sites in the country, throughout the year. With the gradual stabilization of medical needs, and as other organizations increased their activities, MSF’s medical projects in the Juba PoC sites were handed over to the International Medical Corps, South Sudan Red Cross, and Health Link South Sudan in August.</p>
<h3>Unity State</h3>
<p>The rapidly worsening security situation in January forced the evacuation of international staff from Bentiu. In April MSF was forced to stop providing TB and HIV care in the hospital because of increased violence. The town’s residents fled to the nearby UN compound, where the population swelled from 6,000 people to more than 22,000 in a matter of days.</p>
<p>By the end of the year, the number had increased to 40,000. At the PoC site, MSF maintained a 24-hour emergency room and provided more than 10,000 outpatient consultations, treated nearly 1,000 children for severe <a href="http://www.doctorswithoutborders.org/our-work/medical-issues/malnutrition">malnutrition</a>, and performed 300 emergency surgical interventions, 83 percent of which were conflict-related—mostly gunshot wounds. Tens of thousands of children were vaccinated against <a href="http://www.doctorswithoutborders.org/our-work/medical-issues/measles">measles</a> inside and outside the PoC. MSF ran mobile clinics and set up both a general and an antenatal clinic for people outside the site. Another team maintained a program of comprehensive medical services for some 70,000 <a href="http://www.doctorswithoutborders.org/country-region/sudan">Sudanese</a> refugees at Yida camp, and undertook a pneumococcal vaccination campaign—the first ever in a refugee setting. Some 10,000 children under the age of two were vaccinated. MSF also has various decentralized clinics and malaria points throughout the PoC.</p>
<p>In Leer, the international MSF team was evacuated in January due to increased insecurity. Shortly afterwards, 240 South Sudanese MSF hospital staff were forced to escape into the bush with their families and some of the most severely injured patients. By mid-April, the local population had begun to return to the town and in May medical activities resumed. By this time malnutrition in the area had reached crisis levels, and during May and June MSF treated more patients for malnutrition than in all of 2013. Along with the therapeutic feeding program, MSF also provides primary health care for the violence-affected, displaced population through mobile clinics.</p>
<h4>Video</h4>
<p><strong>South Sudan | A Hospital Destroyed, A Community Devastated</strong></p>
<p></p><div class="media-youtube-video media-element file-wysiwyg media-youtube-1">
<iframe class="media-youtube-player" width="580" height="435" title="South Sudan | A Hospital Destroyed, A Community Devastated" src="//www.youtube.com/embed/-zlgLu9_58Y?wmode=opaque" frameborder="0" allowfullscreen="">Video of South Sudan | A Hospital Destroyed, A Community Devastated</iframe>
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<h3>Jonglei State</h3>
<p>Some 70,000 people fled the town of Bor as a result of violence and the state hospital was ransacked. In April, an MSF team helped the health ministry repair the hospital and resume basic medical activities. MSF now provides support in the emergency room, pharmacy, pediatric inpatient department, and with vaccinations. A team also treated people wounded during an attack at Bor airport. MSF had long supported Lankien Hospital, and in 2014 began emergency surgery to treat the increasing number of war wounded. Of the 910 major surgical interventions performed at the hospital, 76 percent were violence-related. There was also a massive outbreak of <a href="http://www.doctorswithoutborders.org/our-work/medical-issues/kala-azar-leishmaniasis">kala azar</a> (visceral leishmaniasis) and more than 6,000 patients were treated.</p>
<p>Insecurity in Pibor in 2013 caused MSF to withdraw from a fixed health center and operate instead through mobile clinics. By July 2014, the situation had stabilized and MSF resumed activities in Pibor town, including basic health consultations, inpatient services, and maternity care. Teams also offered health care in nearby Gumuruk, Lekwongole, and Old Fangak, areas regularly affected by the war. In February 2016, MSF was forced to leave the compound in Pibor due to <a href="https://www.doctorswithoutborders.org/article/week-extraordinary-violence-pibor-south-sudan">heavy fighting</a> and shelter in the UN base on the other side of town. The MSF compound was then <a href="https://www.doctorswithoutborders.org/article/south-sudan-looting-pibor-medical-center-leaves-thousands-without-care">looted</a>, and medical supplies, therapeutic food, and even patients beds were stolen. Anything that was not taken, including drugs and medical documents, was strewn around the compound. MSF continues to treat patients, particularly young children suffering from malaria and other infections, at the UN compound. </p>
<h3>Upper Nile State</h3>
<p>In a pre-existing project at Nasir Hospital, a monthly average of 4,100 consultations were carried out until heavy fighting broke out nearby. The town’s population fled and the hospital was evacuated in May. MSF staff visiting in June found the hospital completely looted and the town deserted. They had no way of knowing the whereabouts or the health status of those who had fled.</p>
<p>Due to mounting insecurity, MSF had to stop working in the Malakal Public Hospital in April and rapidly opened a clinic in the PoC where 20,000 people were sheltering. In Melut, teams provided medical care to those people displaced by violence, which included treating them for kala azar and TB. As the health situation in the refugee camps stabilized over the year, MSF reduced its number of outpatient clinics.</p>
<h3>Lakes State</h3>
<p>MSF provided basic and specialist health care, including vaccinations, in Minkamman camp, Awerial.</p>
<p>Around 95,000 displaced people live in the camp, and more have settled in the surrounding areas. Teams carried out more than 52,000 outpatient consultations and 2,700 <a href="http://www.doctorswithoutborders.org/our-work/medical-issues/mental-health">mental health</a> consultations and also launched vaccination campaigns against measles, polio, <a href="http://www.doctorswithoutborders.org/our-work/medical-issues/cholera">cholera</a>, and <a href="http://www.doctorswithoutborders.org/our-work/medical-issues/meningitis">meningitis</a>.</p>
<p>Following a measles outbreak in Cueibet county in late March, MSF provided support to the health ministry and organized a vaccination campaign against measles and polio which reached 32,700 children under five.</p>
<h3>Northern Bahr El Ghazal State</h3>
<p>In Pamat, close to the border with Sudan, MSF continued to offer basic and specialist medical care to people displaced by conflict. Staff distributed relief items and provided health consultations to new arrivals in December. Since 2008, MSF has supported Aweil Civil Hospital, with around-the-clock pediatric and maternity services, including high-risk and emergency obstetric care—more than 7,100 women were admitted to the maternity ward and over 1,500 complicated deliveries were assisted during the year. In addition, MSF treated more than 30,000 people for <a href="http://www.doctorswithoutborders.org/our-work/medical-issues/malaria">malaria</a> in 2014—three times as many as the previous year.</p>
<p>MSF has also supported Yambio State Hospital in Western Equatoria state since 2008, with specialist pediatric and antenatal care, surgery, and treatment for HIV. There are more than 3,000 patients in the treatment program. In Warrap state, MSF runs a small hospital in Gogrial town providing basic and specialist care, including an operating theater for emergency surgery.</p>
<p></p><div class="media media-element-container media-default"><div class="media-element file-default" style="width: 600px; height: 400px;"><div class="media-image-wrapper"><img height="667" width="1000" style="width: 600px; height: 400px;" title="An MSF nurse treats a young child with cerebral malaria." class="media-element file-default" src="https://media.msf.org/Docs/MSF/Media/TR1/e/8/8/3/MSF154668.jpg" alt="" /><div class="field field-name-field-metadata-copyright field-type-text-long field-label-hidden"><div class="field-items"><div class="field-item even">Diana Zeyneb Alhindawi</div></div></div></div><div class="field-name-field-nmetadata-caption">An MSF nurse treats a young child with cerebral malaria.</div>
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<div class="field field-name-field-taxonomy-region field-type-taxonomy-term-reference field-label-above"><div class="field-label">Country / Region:&nbsp;</div><div class="field-items"><div class="field-item even"><a href="/countryregion/south-sudan">South Sudan</a></div></div></div><div class="field field-name-field-getlocation field-type-getlocations-fields field-label-above"><div class="field-label">Location:&nbsp;</div><div class="field-items"><div class="field-item even"><div class="location vcard"><div class="adr"><div class="country-name">South Sudan</div></div></div><div class="getlocations_map_wrapper_inner"><div id="getlocations_map_wrapper_key_6" style="width: 500PX; height: 400PX" ><div class="getlocations_map_canvas" id="getlocations_map_canvas_key_6" style="width: 100%; height: 100%" ></div></div></div>
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</div></div></div></div></div><div class="field-collection-container clearfix"><div class="field field-name-field-summary-image field-type-field-collection field-label-above"><div class="field-label">Summary image:&nbsp;</div><div class="field-items"><div class="field-item even"><div class="field-collection-view clearfix view-mode-full field-collection-view-final"><div class="entity entity-field-collection-item field-collection-item-field-summary-image clearfix">
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<div class="field field-name-field-media-summary-image field-type-image field-label-above"><div class="field-label">Image:&nbsp;</div><div class="field-items"><div class="field-item even"><img src="/sites/usa/files/images/msf189881_medium.jpg" width="1000" height="667" /></div></div></div><div class="field field-name-field-nmetadata-caption field-type-text-long field-label-above"><div class="field-label">Caption:&nbsp;</div><div class="field-items"><div class="field-item even"><p>An MSF community health promoter tests a child for malaria at an outdoor support clinic in Thaker, Leer County, South Sudan.</p>
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</div></div></div></div></div>Thu, 26 Dec 2013 12:28:30 +0000Artem Kolotilkin51126 at https://www.doctorswithoutborders.orghttps://www.doctorswithoutborders.org/country-region/south-sudan#commentsSouth Africahttps://www.doctorswithoutborders.org/country-region/south-africa
<div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even"><h2>South Africa: Latest MSF Updates</h2>
<ul><li><a href="https://www.doctorswithoutborders.org/article/south-africa-new-drug-offers-hope-patients-fighting-drug-resistant-tuberculosis">South Africa: New Drug Offers Hope for Patients Fighting Drug-Resistant Tuberculosis</a></li>
<li><a href="https://www.doctorswithoutborders.org/article/south-africa-should-override-patent-key-hiv-medicine-after-widespread-stock-out-problem">South Africa Should Override Patent on Key HIV Medicine After Widespread Stock Out Problem</a></li>
<li><a href="https://www.doctorswithoutborders.org/article/displaced-xenophobia-south-africa">Displaced by Xenophobia in South Africa</a></li>
<li><a href="https://www.doctorswithoutborders.org/article/south-africa-msf-assists-people-displaced-xenophobic-violence">South Africa: MSF Assists People Displaced by Xenophobic Violence</a></li>
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<p></p><div class="media-element file-default" style=" width: 1756px;"><div class="media-image-wrapper"><img height="1628" width="1756" class="media-element file-default" style=" width: 1756px;" src="/sites/usa/files/map_south_africa_2016_0.jpg" alt="" title="" /></div></div>
<p><em>This information is excerpted from MSF’s 2016 </em><em><em><a href="http://www.msf.org/sites/msf.org/files/msf_activity_report_2016_web.pdf">International Activity Report</a>.</em></em></p>
<p>South Africa has the largest HIV patient cohort in the world and has helped to lead efforts to gain access to new treatments for multidrug-resistant tuberculosis (MDR-TB). In KwaZulu-Natal province, MSF’s HIV/ TB project in uThungulu district aims to be the first site in South Africa to meet the United Nations 90-90-90 targets, where 90 percent of all people living with HIV know their status, 90 percent are on antiretroviral (ARV) treatment, and 90 percent have reached the stage where the virus has been suppressed. In 2016, MSF tested 56,029 individuals, supported 2,370 male circumcisions, and distributed 1,573,756 condoms.</p>
<p>In partnership with the city and the organization mothers2mothers, MSF’s Khayelitsha project near Cape Town established 13 postnatal “Moms and Tots” clubs where women and their babies could get one-stop services for HIV and other health issues. MSF fought for access to new drugs for patients in Khayelitsha and nationally. South Africa now has national access to the new TB drug bedaquiline, and in Khayelitsha MSF had the largest national cohort on another promising new medication, delamanid, with 61 new patients initiated on treatment in 2016.</p>
<p>With the Department of Health in North West province, MSF expanded access to care for victims of sexual violence in Rustenburg, in the platinum mining belt. An MSF survey showed that one in four women in Bojanala district had been raped in their lifetime, and that half had experienced some form of sexual or intimate partner violence, but 95 percent had never told a health care worker.</p>
<p>MSF supported three Kgomotso health care facilities providing a package of medical, legal, and psychosocial care to victims of sexual violence—including a forensic examination, post-exposure prophylaxis (PEP) to prevent HIV and other sexually transmitted infections, and psychosocial support. In 2016, 290 survivors were treated.</p>
<p>MSF is a founding member of the Fix the Patent Laws coalition, 32 patient groups and organizations campaigning for reform of South Africa’s intellectual property laws to improve access to affordable medicines. Following years of pressure, the South African Department of Trade and Industry released a new intellectual policy consultative framework in 2016.</p>
<p>The Stop Stockouts Project, a civil society consortium supported by MSF and other organizations, monitors the availability of essential drugs in clinics across the country and pushes for the rapid resolution of stockouts and shortages. In 2016, the project received 605 reports of stockouts and trained 3,454 patients and activists. </p>
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<div class="field field-name-field-media-image field-type-image field-label-hidden"><div class="field-items"><div class="field-item even"><img src="http://media.msf.org/Docs/MSF/Media/TR1/b/f/e/6/MSF124652.jpg" width="1000" height="667" /></div></div></div></div>
</div></div></div></div></div><div class="field-collection-container clearfix"><div class="field field-name-field-summary-image field-type-field-collection field-label-above"><div class="field-label">Summary image:&nbsp;</div><div class="field-items"><div class="field-item even"><div class="field-collection-view clearfix view-mode-full field-collection-view-final"><div class="entity entity-field-collection-item field-collection-item-field-summary-image clearfix">
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<div class="field field-name-field-media-summary-image field-type-image field-label-above"><div class="field-label">Image:&nbsp;</div><div class="field-items"><div class="field-item even"><img src="http://media.msf.org/Docs/MSF/Media/TR1/b/f/e/6/MSF124652.jpg" width="1000" height="667" /></div></div></div><div class="field field-name-field-nmetadata-country field-type-text field-label-above"><div class="field-label">Country:&nbsp;</div><div class="field-items"><div class="field-item even">South Africa</div></div></div><div class="field field-name-field-nmetadata-caption field-type-text-long field-label-above"><div class="field-label">Caption:&nbsp;</div><div class="field-items"><div class="field-item even"><p>Adherence clubs for HIV+ patients has been proven a successful model in strengthening their treatment, adherence, and outcomes.</p>
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</div></div></div></div></div>Thu, 26 Dec 2013 12:19:17 +0000Artem Kolotilkin51121 at https://www.doctorswithoutborders.orghttps://www.doctorswithoutborders.org/country-region/south-africa#commentsSomaliahttps://www.doctorswithoutborders.org/country-region/somalia
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<div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even"><h3><strong>June 2017: Malnutrition and Pediatric Treatment Underway in Galkayo North</strong></h3>
<p>Nearly four years after withdrawing its teams from Somalia, Doctors Without Borders/Médecins Sans Frontières (MSF) has started treating patients again in the country. Teams are providing support to Mudug Regional Hospital, Galkayo North, in Somalia’s Puntland region, in collaboration with the Ministry of Health.</p>
<p>MSF began supporting the hospital’s therapeutic feeding program in May 2017 and the pediatric ward in June. With an average of 10 new admissions per day, medical staff in the intensive therapeutic feeding center have already treated 349 children under the age of five for severe acute malnutrition, with patient numbers peaking at 111 at one time.</p>
<p>A total of 201 children have also been admitted to an isolation ward and treated for <a href="/node/50551">measles</a>. In addition, MSF has admitted 100 children to the pediatric ward and provided 2,297 outpatient pediatric consultations since the beginning of June.</p>
<p>Since <a href="/node/45281">withdrawing its teams from Somalia</a> four years ago due to a series of extreme attacks on its staff, MSF has continuously monitored the situation in the country and re-engaged with the relevant authorities, assessing whether conditions would allow its staff to operate safely and humanitarian assistance to be delivered respectfully. MSF reiterates today the need for all parties to the conflict to support its medical assistance to the Somali people and to respect the safety of the humanitarian aid workers who risk their lives to care for them.</p>
<p>Because of its past experience, MSF’s return to Somalia is both cautious and modest. Its planned medical and humanitarian programs in Puntland will be on a limited scale for now. MSF’s presence in Somalia, the scope of its programs, and the potential expansion of its activities to other regions in Somalia will fully depend on the acceptance, facilitation, and active support received from the authorities and communities that MSF serves.</p>
<h4>Why are we there?</h4>
<ul><li>Armed conflict</li>
<li>Endemic/epidemic disease</li>
<li>Health care exclusion</li>
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<h4><div class="media-element file-default" style="width: 600px; height: 362px;"><div class="media-image-wrapper"><img height="827" width="1371" style="width: 600px; height: 362px;" class="media-element file-default" src="/sites/usa/files/somalia_map_2013.jpg" alt="" title="" /></div></div></h4>
<h4>Historical</h4>
<p><strong>In August 2013, MSF closed all of its projects in Somalia after 22 years of continuous operations. </strong></p>
<p><em>This is an excerpt from MSF's <a href="https://www.doctorswithoutborders.org/news-stories/international-activity-report/activity-report-2013">2013 International Activity Report</a>:</em></p>
<p>Leaving Somalia was an extremely difficult decision to make. A series of violent attacks on Doctors Without Borders/Médecins Sans Frontières (MSF) personnel took place with the tacit acceptance—or active complicity—of armed groups and civilian authorities. The minimal conditions necessary for operations were not respected, and hence MSF ceased supporting health facilities in Somalia by mid-September 2013, handing them over to government entities and humanitarian organizations where possible.</p>
<p></p><div class="media media-element-container media-default"><div class="media-element file-default" style="width: 600px; height: 400px;"><div class="media-image-wrapper"><img height="666" width="1000" style="width: 600px; height: 400px;" title="A lab technician tests for tuberculosis at Galkayo Hospital." class="media-element file-default" src="https://media.msf.org/Docs/MSF/Media/TR1/9/8/c/a/MSF17991.jpg" alt="" /><div class="field field-name-field-metadata-copyright field-type-text-long field-label-hidden"><div class="field-items"><div class="field-item even">Siegfried Modola</div></div></div></div><div class="field-name-field-nmetadata-caption">A lab technician tests for tuberculosis at Galkayo Hospital.</div>
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<p>Although the humanitarian situation has improved since the nutritional crisis of 2011, the ongoing conflict in the south-central regions, together with natural disasters and seasonal outbreaks of disease, put huge strains on the weak health care system. In many parts of Somalia, access to health care is extremely limited and mortality rates for pregnant women and young children are among the highest in the world. Hundreds of thousands of Somalis remain displaced inside the country and in refugee camps across Somalia’s borders, living a precarious existence exposed to many forms of violence and extortion.</p>
<p>MSF did not want to leave Somalia but was left with little choice, and continues to support Somali refugees in <a href="http://www.doctorswithoutborders.org/country-region/ethiopia">Ethiopia</a>, <a href="http://www.doctorswithoutborders.org/country-region/kenya">Kenya</a>, and <a href="http://www.doctorswithoutborders.org/country-region/yemen">Yemen</a>.</p>
<h3>In and Around Mogidishu</h3>
<p>Nine kilometers northwest of Mogadishu, in Dayniile, MSF supported a 60-bed hospital with an emergency room, operating theater, intensive care unit, pediatric unit, feeding center, and maternity facilities. The team performed 646 surgical procedures and over 8,272 consultations in 2013.</p>
<p>MSF’s 40-bed hospital in the Jaziira district of Mogadishu, which mostly catered to displaced populations, carried out some 25,700 consultations and 2,200 hospital admissions this year, and treated over 330 severely malnourished children.</p>
<p>To improve access to quality basic and specialist health care for children, MSF ran the only pediatric hospital in Mogadishu, in Hamar Weyne. The hospital had isolation wards for children suffering from <a href="http://www.doctorswithoutborders.org/our-work/medical-issues/measles">measles</a> or acute watery diarrhea and a nutrition center that treated 3,800 children between January and August.</p>
<p>MSF also ran health clinics for displaced populations and residents in the Wadajir, Dharkenley, and Yaaqshiid districts. These focused on maternal and child health and were able to respond to sudden outbreaks of disease such as <a href="http://www.doctorswithoutborders.org/our-work/medical-issues/cholera">cholera</a>, treat peaks of <a href="http://www.doctorswithoutborders.org/our-work/medical-issues/malnutrition">malnutrition</a> through feeding programs, and participate in mass vaccinations against polio, which had made a resurgence in the country. Over 100,000 consultations were carried out at these health facilities prior to MSF’s departure. All drugs and supplies from these clinics were donated to other aid organizations in Mogadishu, and the Dharkenley clinic has continued operations. </p>
<h3>Bay Region</h3>
<p>MSF began supporting Dinsor Hospital in Bay region in 2002. It is the main referral hospital for the entire region, and is especially active in providing maternity services and treating malnutrition, <a href="http://www.doctorswithoutborders.org/our-work/medical-issues/tuberculosis">tuberculosis</a> (TB), and <a href="http://www.doctorswithoutborders.org/our-work/medical-issues/kala-azar-leishmaniasis">kala azar</a> (visceral leishmaniasis). In 2013, the team at the 60-bed hospital performed 16,208 outpatient consultations, around 1,458 antenatal consultations, and treated more than 680 malnourished children. </p>
<p></p><div class="media media-element-container media-default"><div class="media-element file-default" style="width: 600px; height: 337px;"><div class="media-image-wrapper"><img height="561" width="1000" style="width: 600px; height: 337px;" title="MSF outreach worker at a malnutrition program for internally displaced people." class="media-element file-default" src="https://media.msf.org/Docs/MSF/Media/TR1/8/d/e/6/MSF135980.jpg" alt="" /><div class="field field-name-field-metadata-copyright field-type-text-long field-label-hidden"><div class="field-items"><div class="field-item even">Muhammad Daoud/MSF</div></div></div></div><div class="field-name-field-nmetadata-caption">MSF outreach worker at a malnutrition program for internally displaced people.</div>
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<h3>Lower Shabelle Region</h3>
<p>The Afgooye district hospital serves displaced people and residents of the Afgooye Corridor with an outpatient and 30-bed inpatient department, emergency room, maternity facility, and an outpatient feeding program. Between January and September, the hospital conducted 11,408 medical consultations, admitted 738 patients to its wards and assisted the delivery of 953 babies. The Qatar Red Crescent Society assumed support of the hospital following MSF’s withdrawal. </p>
<h3>Middle Shabelle Region</h3>
<p>MSF provided outpatient care, maternal and child health services, vaccinations, and nutritional support at the Jowhar maternity hospital and health centers in Kulmis, Bulo Sheik, Gololey, Balcad, and Mahaday. The Mahaday and Gololey facilities also treated TB. Mahaday clinic closed in March 2013 due to insecurity and the other clinics were handed over to the International Medical Corps (IMC) in September. More than 60,000 consultations were performed, 1,040 deliveries assisted, and 8,447 women and children received vaccinations. </p>
<h3>Mudug Region</h3>
<p>MSF ran projects in two referral hospitals in the divided city of Galkayo. In the Ministry of Health’s referral hospital in Galkayo North, MSF offered pediatric outpatient and inpatient care, maternity services, feeding programs, and TB treatment. MSF teams carried out 33,824 consultations in 2013. In addition, MSF ran a satellite program for TB treatment in Burtinle in Nugal region.</p>
<p>In the hospital in Galkayo South, MSF provided surgery and pediatric care, maternity services, nutrition programs, TB treatment, and immunizations. Two mobile clinics also provided primary health care in Galmudug region. Some 44,071 people received assistance through the hospital and the clinics between January and September. Management of the hospital was passed to the Mudug Development Organization, which now works in partnership with two international medical organizations to continue these vital services. </p>
<h3>Middle Juba</h3>
<p>MSF’s hospital in the small rural town of Marere served as the referral hospital for the whole of Middle and Lower Juba and Gedo regions, providing basic and specialist health care, TB treatment, nutritional services, and emergency obstetric care to a huge catchment population. In addition, mobile teams covered the towns of Ketoy and Osman Moto and delivered basic health care to children under 12 and nutritional care to malnourished children under five. A small fixed clinic in Jilib had facilities to treat malnutrition, measles, and cholera. Over 68,000 medical interventions were carried out through this program between January and August. </p>
<h3>Lower Juba</h3>
<p>In the port city of Kismayo, MSF ran an inpatient nutrition program for children under five, with special wards for those suffering from measles and cholera. This facility opened during the nutritional crisis of 2011 and saw a steady stream of children thereafter: 5,183 received treatment between January and September 2013. The International Committee of the Red Cross opened a similar structure at Kismayo Hospital in October to compensate for MSF’s withdrawal. </p>
<h3>Somaliland</h3>
<p>MSF had been supporting the inpatient, maternity, and surgical facilities of the 160-bed Burao Hospital in the Togdheer region of Somaliland since 2011. Prior to its withdrawal, MSF conducted 775 surgical interventions, admitted 1,602 people to the inpatient department, and assisted in the birth of 720 babies.</p>
<p>MSF also intervened in three prisons in Somaliland, carrying out medical consultations, improving water and sanitation facilities, and distributing relief supplies. </p>
<p><strong><em>At the end of 2013, MSF had 1,188 staff in Somalia. MSF first worked in the country in 1979.</em></strong></p>
</div></div></div><div class="field field-name-field-taxonomy-region field-type-taxonomy-term-reference field-label-above"><div class="field-label">Country / Region:&nbsp;</div><div class="field-items"><div class="field-item even"><a href="/countryregion/somalia">Somalia</a></div></div></div><div class="field field-name-field-getlocation field-type-getlocations-fields field-label-above"><div class="field-label">Location:&nbsp;</div><div class="field-items"><div class="field-item even"><div class="location vcard"><div class="adr"><div class="country-name">Somalia</div></div></div><div class="getlocations_map_wrapper_inner"><div id="getlocations_map_wrapper_key_8" style="width: 500PX; height: 400PX" ><div class="getlocations_map_canvas" id="getlocations_map_canvas_key_8" style="width: 100%; height: 100%" ></div></div></div>
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</div></div></div>Wed, 25 Dec 2013 19:29:14 +0000Artem Kolotilkin51016 at https://www.doctorswithoutborders.orghttps://www.doctorswithoutborders.org/country-region/somalia#commentsSierra Leonehttps://www.doctorswithoutborders.org/country-region/sierra-leone
<div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even"><h2>Sierra Leone: Latest MSF Updates</h2>
<ul><li><a href="http://www.doctorswithoutborders.org/article/new-ebola-case-confirmed-sierra-leone">New Ebola Case Confirmed in Sierra Leone</a></li>
<li><a href="http://www.doctorswithoutborders.org/article/ebola-survivors-now-face-different-challenges">Ebola Survivors Now Face Different Challenges</a></li>
<li><a href="http://www.doctorswithoutborders.org/article/fighting-ebola-sierra-leone-%E2%80%9Cwe-go-heart-community%E2%80%9D">Fighting Ebola in Sierra Leone: “We Go Into the Heart of a Community”</a></li>
<li><a href="https://www.doctorswithoutborders.org/article/alive-again-survivor%E2%80%99s-account-life-after-ebola">Alive Again: A Survivor’s Account of Life After Ebola</a></li>
</ul><p></p><div class="media-element file-default" style=" width: 1458px;"><div class="media-image-wrapper"><img height="1435" width="1458" class="media-element file-default" style=" width: 1458px;" src="/sites/usa/files/map_sierra_leone_2016.jpg" alt="" title="" /></div></div>
<p><em>This information is excerpted from MSF’s 2016 </em><em><em><a href="http://www.msf.org/sites/msf.org/files/msf_activity_report_2016_web.pdf">International Activity Report</a>.</em></em></p>
<p>Sierra Leone was finally declared Ebola-free on March 17, 2016, but the country struggled to rebuild its shattered health system. Access to medical care was already limited before the epidemic, and an estimated 10 percent of the country’s health professionals were among the 3,950 people killed by the virus.</p>
<p>The Ebola survivors’ clinic, opened by MSF in July 2015 to help patients with complications, was handed over to the Ministry of Health (MOH) at the end of September 2016. The clinic provided medical treatment and mental health care to more than 400 survivors and their families, and also promoted safe sex and malaria prevention. When survivors reported experiencing stigma, MSF sent health promoters to educate their communities about the disease. </p>
<p>Sierra Leone had some of the worst health indicators even before the Ebola epidemic, especially for maternal and child mortality. In Tonkolili district, MSF supported the pediatric and maternity wards, neonatal services, and blood transfusion laboratory at Magburaka district hospital and assisted the Magburaka mother and child health post with staff and supplies. MSF provided emergency obstetric care in a community health center in Yoni Chiefdom, Hinistas. Teams conducted 21,180 outpatient and 6,245 antenatal consultations, admitted 2,996 children to the pediatric ward, and assisted 1,457 deliveries.</p>
<p>MSF launched a project in Koinadugu in April, rehabilitating Kabala hospital, growing the pediatric ward from 15 to 45 beds, and creating a three-bed neonatal ward. Teams provided care to 1,185 pregnant women, assisted 783 deliveries, including 111 Caesarean sections, and registered 1,240 people for family planning. The project also provided health care to Ebola survivors, and screening for malaria and HIV. Teams monitored the nutrition situation and responded to emergencies and disease outbreaks. In May, 65,159 children were vaccinated against measles. </p>
<h2>Ebola Update</h2>
<h3>March 17, 2016</h3>
<p>On March 17, 2016, Sierra Leone was declared free of Ebola for the second time. The first outbreak in Sierra Leone was declared to have ended on November 7, 2015, but a confirmed death was reported on January 14 and an additional case was identified on January 20.</p>
<p>Vigilance and ability to respond quickly to new possible cases must be maintained. Flare-ups after the end of the epidemic remain a possibility. MSF will maintain an emergency response capacity in the country.</p>
<p>MSF developed activities to treat people who suffered from the virus and continue to provide medical and psychosocial services to some of the country’s 4,000 Ebola survivors in Freetown and Tonkolili District. Non-Ebola health activities in several districts of the country (Kabala, Magburaka, Kenema) have started, as many components of the health system need to be strengthened.</p>
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<div class="field field-name-field-taxonomy-issues field-type-taxonomy-term-reference field-label-above"><div class="field-label">Issues:&nbsp;</div><div class="field-items"><div class="field-item even"><a href="/issues/msf-action">MSF ACTION</a></div></div></div><div class="field field-name-field-taxonomy-region field-type-taxonomy-term-reference field-label-above"><div class="field-label">Country / Region:&nbsp;</div><div class="field-items"><div class="field-item even"><a href="/countryregion/sierra-leone">Sierra Leone</a></div></div></div><div class="field field-name-field-getlocation field-type-getlocations-fields field-label-above"><div class="field-label">Location:&nbsp;</div><div class="field-items"><div class="field-item even"><div class="location vcard"><div class="adr"><div class="country-name">Sierra Leone</div></div></div><div class="getlocations_map_wrapper_inner"><div id="getlocations_map_wrapper_key_9" style="width: 500PX; height: 400PX" ><div class="getlocations_map_canvas" id="getlocations_map_canvas_key_9" style="width: 100%; height: 100%" ></div></div></div>
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<div class="field field-name-field-media-summary-image field-type-image field-label-above"><div class="field-label">Image:&nbsp;</div><div class="field-items"><div class="field-item even"><img src="http://media.msf.org/Docs/MSF/Media/TR1/e/4/b/c/MSF127196.jpg" width="1000" height="665" /></div></div></div><div class="field field-name-field-nmetadata-country field-type-text field-label-above"><div class="field-label">Country:&nbsp;</div><div class="field-items"><div class="field-item even">Sierra Leone</div></div></div><div class="field field-name-field-nmetadata-ost field-type-text field-label-above"><div class="field-label">Original submission title:&nbsp;</div><div class="field-items"><div class="field-item even">Safe Delivery Sierra Leone 2012 10</div></div></div><div class="field field-name-field-nmetadata-caption field-type-text-long field-label-above"><div class="field-label">Caption:&nbsp;</div><div class="field-items"><div class="field-item even"><p>MSF medical staff provide care to women with complications during pregnancy at the Gondama Referral Center, in Bo.</p>
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</div></div></div></div></div>Wed, 25 Dec 2013 19:24:25 +0000Artem Kolotilkin51011 at https://www.doctorswithoutborders.orghttps://www.doctorswithoutborders.org/country-region/sierra-leone#comments